Joint Arthroplasty Systems, Methods, and Components

ABSTRACT

Surgical implant systems, methods, and components are described herein. More particularly, the disclosure relates to joint arthroplasty systems, methods, and components. Particular embodiments described herein can be used to modify the subtalar joint (e.g., posterior facet of the subtalar joint), calcaneocuboid, talonavicular, and any other suitable joint. An exemplary implant system comprises a first implant component, a second implant component, and an insert.

FIELD

The disclosure relates generally to surgical implant systems, methods,and components. More particularly, the disclosure relates to jointarthroplasty systems, methods, and components. Particular embodimentsdescribed herein can be used to modify the subtalar joint (e.g.,posterior facet of the subtalar joint), calcaneocuboid, talonavicular,and any other suitable joint.

BACKGROUND

The subtalar joint is a joint in the foot formed between the talus andcalcaneus and it serves several important roles in human gait. Forexample, the subtalar joint allows for inversion and eversion of therear portion of the foot about the lengthwise axis of the foot andabduction and adduction relative to the vertical axis of the tibia. Inaddition, the subtalar joint allows both pronation and supination tooccur and serves to translate rotation of the foot to the tibia and viceversa. The subtalar joint is composed of three articulating facetsbetween the talus and the calcaneus: the anterior, middle, and posteriorfacets. The anterior and middle facets produce a gliding motion whereasthe posterior facet produces a complex triaxial movement due to itssaddle shape.

Commonly, inflammatory arthritis, such as rheumatoid arthritis, affectsthe subtalar joint and requires treatment. Rheumatoid arthritis is knownto destroy the subtalar joint through synovitis and, in some cases,directly damages the cartilage in the joint or the tendons around theankle. In addition to inflammatory arthritis, other afflictions can alsoaffect the subtalar joint, such as eccentric forces that act on thesubtalar joint and erode the joint causing pain and discomfort.

Various forms of treatment can be used to treat the afflictions thataffect the subtalar joint. For example, various non-operativetreatments, such as activity modification, weight-loss, prescriptionshoes, and/or medication can be used. Alternatively, when non-operativetreatments are not successful at providing adequate treatment, operativetreatments can be used, such as arthrodesis—the fusing of the talus tothe calcaneus. Arthrodesis is generally accomplished by removing anyremnants of cartilage from the subtalar joint and placing screws and/orbone grafts across the subtalar joint. This treatment, however, presentsseveral disadvantages. For example, it permanently fixes the talus tothe calcaneus, eliminating movement between these bones, and sometimesresults in pain and discomfort requiring the performance of subsequentprocedures to address these issues.

Therefore, a need exists for improved surgical implant systems, methods,and components for use in joint arthroplasty.

SUMMARY

Various exemplary implant systems, methods, and components are describedherein.

A first exemplary implant system for use in a joint arthroplastycomprises a first implant component, a second implant component, and aninsert. The first implant component has a first implant proximal end, afirst implant distal end, and a first implant body. The first implantbody defines a substantially flat first implant surface, a substantiallyconcave first articulating surface opposably facing the first implantsurface, a first implant protuberance, and a passageway. The firstimplant protuberance extends outward and away from the first implantsurface and toward the first implant distal end from a first implantprotuberance first end to a first implant protuberance second end. Thepassageway extends from a first opening defined on the first implantproximal end to a second opening defined on the first implantprotuberance second end. The second implant component has a secondimplant proximal end, a second implant distal end, and a second implantbody. The second implant body defines a substantially flat secondimplant surface, a recess that extends into the second implant body froma side opposably facing the second implant surface to a recess base, asecond implant protuberance, and a passageway. The second implantprotuberance extends outward and away from the second implant surfaceand toward the second implant distal end from a second implantprotuberance first end to a second implant protuberance second end. Thepassageway extends from a first opening defined on the recess base to asecond opening defined on the second implant protuberance second end.The insert is adapted to be releasably attached to the second implantcomponent and has an insert articulating surface that is substantiallyconvex and adapted to articulate with the first articulating surface.

A second exemplary implant system for use in a joint arthroplastycomprises a first implant component, a second implant component, and aninsert. The first implant component has a first implant proximal end, afirst implant distal end, and a first implant body. The first implantbody defines a substantially flat first implant surface, a substantiallyconcave first articulating surface opposably facing the first implantsurface, a first implant protuberance, and a passageway. The firstimplant protuberance extends outward and away from the first implantsurface and toward the first implant distal end from a first implantprotuberance first end to a first implant protuberance second end. Thepassageway extends from a first opening defined on the first implantproximal end to a second opening defined on the first implantprotuberance second end. The second implant component has a secondimplant proximal end, a second implant distal end, and a second implantbody. The second implant body defines a substantially flat secondimplant surface, a recess, a second implant protuberance, and apassageway. The recess extends into the second implant body from a sideopposably facing the second implant surface to a recess base and fromthe second implant proximal end toward the second implant distal end.The second implant protuberance extends outward and away from the secondimplant surface and toward the second implant distal end from a secondimplant protuberance first end to a second implant protuberance secondend. The passageway extends from a first opening defined on the recessbase to a second opening defined on the second implant protuberancesecond end. The recess has a recess first portion that extends from therecess base and away from the second implant surface and a recess secondportion that extends from the recess first portion and away from thesecond implant surface. The insert is adapted to be releasably attachedto the second implant component and has an insert articulating surfacethat is substantially convex and adapted to articulate with the firstarticulating surface.

A third exemplary implant system for use in a joint arthroplastycomprises a first implant component, a second implant component, and aninsert. The first implant component has a first implant proximal end, afirst implant distal end, and a first implant body. The first implantbody defines a substantially flat first implant surface, a substantiallyconcave first articulating surface opposably facing the first implantsurface, a first implant protuberance, and a passageway. The firstimplant protuberance extends outward and away from the first implantsurface and toward the first implant distal end from a first implantprotuberance first end to a first implant protuberance second end. Thepassageway extends from a first opening defined on the first implantproximal end to a second opening defined on the first implantprotuberance second end. The second implant component has a secondimplant proximal end, a second implant distal end, and a second implantbody. The second implant body defines a substantially flat secondimplant surface, a recess, a second implant protuberance, and apassageway. The recess extends into the second implant body from a sideopposably facing the second implant surface to a recess base and fromthe second implant proximal end toward the second implant distal end.The second implant protuberance extends outward and away from the secondimplant surface and toward the second implant distal end from a secondimplant protuberance first end to a second implant protuberance secondend. The passageway extends from a first opening defined on the recessbase to a second opening defined on the second implant protuberancesecond end. The recess has a recess first portion that extends from therecess base and away from the second implant surface and a recess secondportion that extends from the recess first portion and away from thesecond implant surface. The insert is adapted to be releasably attachedto the second implant component and has an insert articulating surfacethat is substantially convex and adapted to articulate with the firstarticulating surface. The recess first portion has a recess firstportion width along the second implant proximal end and the recesssecond portion has a recess second portion width along the secondimplant proximal end. The recess first portion width is different thanthe recess second portion width.

Additional understanding of the exemplary surgical implant systems,methods, and components can be obtained by review of the detaileddescription, below, and the appended drawings.

BRIEF DESCRIPTION OF THE FIGURES

FIG. 1 is a lateral view of an exemplary human foot highlighting thesubtalar joint.

FIG. 2 is a magnified view of the area indicated in FIG. 1.

FIG. 3 is a perspective view of a first exemplary implant systemdisposed in the subtalar joint of a human foot.

FIG. 4 is a perspective view of the first exemplary implant systemillustrated in FIG. 3, free of the subtalar joint.

FIG. 5 is an exploded view of the exemplary implant system illustratedin FIG. 4.

FIG. 6 is another exploded view of the exemplary implant systemillustrated in FIG. 4.

FIG. 7 is a perspective view of a second exemplary implant systemdisposed in the subtalar joint of a human foot.

FIG. 8 is a perspective view of the second exemplary implant systemillustrated in FIG. 7, free of the subtalar joint.

FIG. 9 is an exploded view of the exemplary implant system illustratedin FIG. 8.

FIG. 10 is another exploded view of the exemplary implant systemillustrated in FIG. 8.

FIG. 11 is a perspective view of a third exemplary implant systemdisposed in the subtalar joint of a human foot.

FIG. 12 is a perspective view of the third exemplary implant systemillustrated in FIG. 11, free of the subtalar joint.

FIG. 13 is an exploded view of the exemplary implant system illustratedin FIG. 12.

FIG. 14 is another exploded view of the exemplary implant systemillustrated in FIG. 12.

FIG. 15 is a perspective view of a fourth exemplary implant systemdisposed in the subtalar joint of a human foot.

FIG. 16 is a perspective view of the fourth exemplary implant systemillustrated in FIG. 15, free of the subtalar joint.

FIG. 17 is an exploded view of the exemplary implant system illustratedin FIG. 16.

FIG. 18 is another exploded view of the exemplary implant systemillustrated in FIG. 16.

FIG. 19 is a perspective view of a fifth exemplary implant system withthe insert partially disposed in the second implant component.

FIG. 20 is an exploded view of the exemplary implant system illustratedin FIG. 19.

FIG. 21 is a magnified view of the area indicated in FIG. 20.

FIG. 22 is another exploded view of the exemplary implant systemillustrated in FIG. 19.

FIG. 23 is a perspective view of a sixth exemplary implant system withthe insert partially disposed in the second implant component.

FIG. 24 is an exploded view of the exemplary implant system illustratedin FIG. 23.

FIG. 25 is another exploded view of the exemplary implant systemillustrated in FIG. 23.

FIG. 26 is a perspective view of a seventh exemplary implant systemdisposed in the subtalar joint of a human foot.

FIG. 27 is a perspective view of the seventh exemplary implant systemillustrated in FIG. 26, free of the subtalar joint.

FIG. 28 is an exploded view of the exemplary implant system illustratedin FIG. 27.

FIG. 29 is another exploded view of the exemplary implant systemillustrated in FIG. 27.

FIG. 30 is a perspective view of an eighth exemplary implant systemdisposed in the subtalar joint of a human foot.

FIG. 31 is a perspective view of the eighth exemplary implant systemillustrated in FIG. 30, free of the subtalar joint.

FIG. 32 is an exploded view of the exemplary implant system illustratedin FIG. 31.

FIG. 33 is another exploded view of the exemplary implant systemillustrated in FIG. 31.

FIG. 34 is a perspective view of a ninth exemplary implant systemdisposed in the subtalar joint of a human foot.

FIG. 35 is a perspective view of the ninth exemplary implant systemillustrated in FIG. 34, free of the subtalar joint.

FIG. 36 is an exploded view of the exemplary implant system illustratedin FIG. 35.

FIG. 37 is another exploded view of the exemplary implant systemillustrated in FIG. 35.

FIG. 38 is a perspective view of a tenth exemplary implant systemdisposed in the subtalar joint of a human foot.

FIG. 39 is a perspective view of the tenth exemplary implant systemillustrated in FIG. 38, free of the subtalar joint.

FIG. 40 is an exploded view of the exemplary implant system illustratedin FIG. 39.

FIG. 41 is another exploded view of the exemplary implant systemillustrated in FIG. 39.

FIG. 42 is a perspective view of an eleventh exemplary implant systemdisposed in the subtalar joint of a human foot.

FIG. 43 is a perspective view of the eleventh exemplary implant systemillustrated in FIG. 42, free of the subtalar joint.

FIG. 44 is an exploded view of the exemplary implant system illustratedin FIG. 43.

FIG. 45 is another exploded view of the exemplary implant systemillustrated in FIG. 43.

FIG. 46 is a flowchart representation of an exemplary method oftreatment.

FIG. 47 is a flowchart representation of a second exemplary method oftreatment.

FIG. 48 is a flowchart representation of a third exemplary method oftreatment.

FIG. 49 is a flowchart representation of a fourth exemplary method oftreatment.

FIG. 50 is a perspective view of a twelfth exemplary implant systemdisposed in the subtalar joint of a human foot.

FIG. 51 is a perspective view of the exemplary implant systemillustrated in FIG. 50, free of the subtalar joint, with the insertpartially disposed in the second implant component.

FIG. 52 is an exploded view of the exemplary implant system illustratedin FIG. 51.

FIG. 53 is another exploded view of the exemplary implant systemillustrated in FIG. 51.

FIG. 54 is a perspective view of a thirteenth exemplary implant systemdisposed in the subtalar joint of a human foot.

FIG. 55 is a perspective view of the exemplary implant systemillustrated in FIG. 54, free of the subtalar joint.

FIG. 56 is an exploded view of the exemplary implant system illustratedin FIG. 54.

FIG. 57 is another exploded view of the exemplary implant systemillustrated in FIG. 54.

DETAILED DESCRIPTION

The following detailed description and the appended drawings describeand illustrate various exemplary surgical implant systems, methods, andcomponents. The description and drawings are exemplary in nature and areprovided to enable one skilled in the art to make and use one or moreexemplary surgical implant systems and/or components, and/or practiceone or more exemplary methods. They are not intended to limit the scopeof the claims in any manner.

The use of “e.g.,” “etc.,” “for instance,” “in example,” and “or” andgrammatically related terms indicates non-exclusive alternatives withoutlimitation, unless otherwise noted. The use of “optionally” andgrammatically related terms means that the subsequently describedelement, event, feature, or circumstance may or may not bepresent/occur, and that the description includes instances where saidelement, event, feature, or circumstance occurs and instances where itdoes not. The use of “exemplary” refers to “an example of” and is notintended to convey a meaning of an ideal or preferred embodiment. Theuse of “attached” and grammatically related terms refers to the fixed,releasable, or integrated association of two or more elements and/ordevices. Thus, the term “attached” and grammatically related termsincludes releasably attaching or fixedly attaching two or more elementsand/or devices. As used herein, the terms “proximal” and “distal” areused to describe opposing axial ends of the particular elements orfeatures being described.

FIGS. 1 and 2 illustrate an exemplary human foot 10 comprising a talus12, calcaneus 14, and subtalar joint 16. The posterior facet 18 of thesubtalar joint 16 is formed by a concave, or substantially concave,surface 20 on the talus 12 and a convex, or substantially convex,surface 22 on the calcaneus 14, as shown in FIG. 2.

While the systems, methods, and components described herein areexemplified by systems and methods for modifying the posterior facet ofthe subtalar joint in a human foot, the systems, methods, and componentsdescribed and illustrated herein can by used to treat any suitableailment or joint within the body of an animal, including, but notlimited to, humans. Skilled artisans will be able to select a suitableailment and/or joint within the body of an animal to utilize a systemand/or method described herein according to a particular embodimentbased on various considerations, including the type of ailment and/orthe structural arrangement at a treatment site. Example jointsconsidered suitable to utilize a system, method, and/or componentdescribed herein include, but are not limited to, the subtalar joint,the talonavicular joint, and the calcaneocuboid joint.

FIGS. 3, 4, 5, and 6 illustrate an exemplary surgical implant system 100comprising a first implant component 102, a second implant component104, and an insert 106. First implant component 102 is adapted to beattached to the talus 12 and second implant component 104 is adapted tobe attached to the calcaneus 14.

First implant component 102 and second implant component 104 can beformed of any suitable material, and skilled artisans will be able toselect a suitable material to form a first implant component and/orsecond implant component according to a particular embodiment based onvarious considerations, including the structural arrangement at animplant site and/or the material forming the insert of an implantsystem. Example materials considered suitable to form a first implantcomponent and/or second implant component include, but are not limitedto, biocompatible materials, materials that can be made biocompatible,ceramics, polymers, polyethylene, ultra-high-molecular-weightpolyethylene (UHMWPE), metals, tantalum, titanium (Ti), and cobaltalloys (e.g., cobalt-chromium (CoCr), cobalt-chromium-molybdenum(CoCrMo)). It is considered advantageous to form a first implantcomponent and/or second implant component of titanium orultra-high-molecular-weight polyethylene (UHMWPE) at least because thesematerials have properties that limit adverse reactions after beingimplanted and have high wearability.

In the illustrated embodiment, first implant component 102 comprises afirst implant proximal end 108, first implant distal end 110, firstimplant body 112, and a plurality of first implant projections 114.

First implant body 112 defines a convex, or substantially convex, firstimplant surface 116 and an opposably facing, or substantially opposablyfacing, concave, or substantially concave, first articulating surface118. Each of the first implant surface 116 and first articulatingsurface 118 has a radius of curvature that extends from the firstimplant proximal end 108 to the first implant distal end 110. Firstimplant surface 116 is smooth, substantially smooth, or uninterruptedand first articulating surface 118 is smooth, substantially smooth, oruninterrupted, such that articulation between articulating surface 118and insert 106 can be accomplished, as described in more detail herein.

While first implant surface 116 has been described as convex, orsubstantially convex, and first articulating surface 118 has beendescribed as concave, or substantially concave, the first implantsurface and/or first articulating surface of a first implant componentcan have any suitable structural arrangement. Skilled artisans will beable to select a suitable structural arrangement for the first implantsurface and/or first articulating surface of a first implant componentaccording to a particular embodiment based on various considerations,including the structural arrangement at a desired implant site. Examplestructural arrangements considered suitable for the first implantsurface and/or first articulating surface of a first implant componentinclude, but are not limited to, curved, nonuniform, uniform, flat,substantially flat, concave, substantially concave, convex,substantially convex, and any other structural arrangement consideredsuitable for a particular application.

First implant surface 116 and first articulating surface 118 can haveany suitable radius of curvature and first implant component can haveany suitable dimensions, and skilled artisans will be able to select asuitable radius of curvature for an implant surface and firstarticulating surface of a first implant component and/or suitabledimensions for a first implant component according to a particularembodiment based on various considerations, including the structuralarrangement at a desired implant site. For example, one or more firstimplant components can be provided in a kit such that one, two, at leasttwo, or a plurality of the implant components has/have a differentradius of curvature on an implant surface and/or first articulatingsurface and/or different dimensions. It is considered advantageous toprovide a variety of differently sized first implant components at leastbecause this provides a mechanism for matching a first implant componentwith the anatomy at an implant site. It is considered advantageous for afirst implant component to have a thickness that is able to withstandthe forces placed on the first implant component and/or an implant site(e.g., subtalar joint) during use (e.g., walking, running) and prevent,or substantially prevent, fracture of and/or damage to the first implantcomponent.

While each of the first implant surface 116 and first articulatingsurface 118 has been described as having a radius of curvature thatextends from the first implant proximal end 108 to the first implantdistal end 110, the first implant body of a first implant component candefine a radius of curvature along any suitable length of a surface.Skilled artisans will be able to select a suitable length to define aradius of curvature on a surface according to a particular embodimentbased on various considerations, including the structural configurationat an implant site. Example lengths considered suitable to define aradius of curvature on the surface of a first implant component include,but are not limited to, from the first implant proximal end to the firstimplant distal end of a first implant component, from a location distalto the first implant proximal end to the first implant distal end of afirst implant component, between the first implant proximal end and thefirst implant distal end of a first implant component, and from thefirst implant proximal end to a location proximal to the first implantdistal end of a first implant component.

While first implant surface 116 has been described as smooth,substantially smooth, or uninterrupted, the first implant surface of afirst implant component can comprise any suitable texture, roughness,and/or porosity and skilled artisans will be able to select a suitabletexture, roughness, and/or porosity for the first implant surface of afirst implant component according to a particular embodiment based onvarious considerations, including the desired amount of bone ingrowthdesired between a first implant component and the bone at an implantsite. For example, alternative to first implant surface comprising asmooth, substantially smooth, or uninterrupted surface, the firstimplant surface of a first implant component can comprise a porous, orsubstantially porous, surface. It is considered advantageous for thefirst implant surface of a first implant component to have a porous, orsubstantially porous, surface to increase the amount of bone ingrowthbetween a first implant component and the bone at an implant site.

In the illustrated embodiment, each projection of the plurality of firstimplant projections 114 has a first implant projection proximal end 120,first implant projection distal end 122, and extends outward and away,or radially outward, from first implant surface 116 at a 90 degree, orsubstantially 90 degree, angle from a first implant projection first end124 to a first implant projection second end 126. Each projection of theplurality of first implant projections 114 is elongated, is disposedbetween first implant proximal end 108 and first implant distal end 110,and defines a serrated first implant projection second end 126. It isconsidered advantageous for each projection of the plurality of firstimplant projections 114 to define a serrated first implant projectionsecond end 126 at least because this structural configuration provides amechanism for increasing the amount of attachment between first implantcomponent 102 and the surface at an implant site.

The serrated first implant projection second end 126 of each projectionof the plurality of first implant projections 114 is configured suchthat it has a plurality of projection declining surfaces 127. Eachprojection declining surface of the plurality of projection decliningsurfaces 127 extends from a first end 127′ toward first implant distalend 110 to a second end 127″. The first end 127′ is disposed a firstprojection distance from first implant surface 116 and the second end127″ is disposed a second projection distance from first implant surface116. The first projection distance is greater than the second projectiondistance. This configuration is considered advantageous at least becauseit provides a mechanism for reducing the complexity of implanting firstimplant component 102 at an implant site while also preventing, orsubstantially preventing, first implant component 102 from becomingloose after being implanted. For example, during implantation, firstimplant component 102 can be introduced at in implant site without theserrated first implant projection second end 126 of each projection ofthe plurality of projections 114 increasing resistance, or substantiallyincreasing resistance. In addition, after implantation, the serratedfirst implant projection second end 126 of each projection of theplurality of projections 114 will be forced into the treatment site uponthe application of force on first articulating surface 118 and/or towardfirst implant proximal end 108.

While each projection of the plurality of first implant projections 114has been illustrated and described as disposed between the first implantproximal end 108 and first implant distal end 110, a projection can bepositioned at any suitable location on the implant component and canextend any suitable length along the implant component. Skilled artisanswill be able to select a suitable location to position a projection onan implant component and a suitable length for a projection according toa particular embodiment based on various considerations, including thestructural arrangement of the desired implant site. Example positionsand lengths considered suitable for a projection of an implant componentinclude, but are not limited to, a projection that is disposed on theimplant surface of an implant component and extends from the firstimplant proximal end to the first implant distal end, a projection thatis disposed on the implant surface of an implant component and extendsfrom the first implant proximal end to a location proximal to the firstimplant distal end, a projection that is disposed on the implant surfaceof an implant component and extends between the first implant proximalend and the first implant distal end, and a projection that is disposedon the implant surface of an implant component and extends from alocation between the first implant proximal end and the first implantdistal end to the first implant distal end.

While a plurality of first implant projections 114 has been describedand illustrated, any suitable number of projections can be included on afirst implant component, and skilled artisans will be able to select asuitable number of projections for inclusion on a first implantcomponent according to a particular embodiment based on variousconsiderations, including the structural arrangement at a desiredimplant site. Example number of projections considered suitable toinclude on a first implant component include, but are not limited to,one, at least one, two, three, four, five, a plurality, and any othernumber considered suitable for a particular application. If more thanone implant projection is included on a first implant component, theimplant projections can be disposed on a first implant surface in anysuitable structural configuration. For example, the implant projectionscan be disposed linearly between a first implant proximal end and afirst implant distal end and/or staggered between a first implantproximal end and a first implant distal end.

While the first implant projection second end 126 of each projection ofthe plurality of first implant projections 114 has been described andillustrated as serrated, the first implant projection second end of aprojection can have any suitable structural configuration. Skilledartisans will be able to select a suitable structural configuration forthe first implant projection second end of a projection according to aparticular embodiment based on various considerations, including thestructural arrangement of a desired implant site. Example structuralconfigurations considered suitable for the first implant projectionsecond end of a projection include, but are not limited to, tapered,pointed, smooth, substantially smooth, porous, substantially porous,serrated, serrated having one or more identical teeth, serrated having afirst tooth and a second tooth with a different structuralconfiguration, serrated having at least two teeth with differentstructural configurations, serrated having a first set of teeth with afirst configuration and a second set of teeth with a second structuralconfiguration different than the first structural configuration, and anyother structural configuration considered suitable for a particularapplication. For example, a projection declining surface of theplurality of projection declining surfaces 127 and/or any other portionof a first implant projection of the plurality of first implantprojections 114 can include one or more cavities or comprise a porous,or substantially porous, surface to allow for bone ingrowth. Examplestructural configurations for a tooth of a serrated first implantprojection second end include, but are not limited to, triangular,square, circular, curved, and any other structural configurationconsidered suitable for a particular application.

In the illustrated embodiment, second implant component 104 comprises asecond implant proximal end 130, second implant distal end 132, secondimplant body 134, and a plurality of second implant projections 136.

Second implant body 134 defines a concave, or substantially concave,second implant surface 138, recess 139, and a plurality of recessprojections 140. Second implant surface 138 is smooth, substantiallysmooth, or uninterrupted and has a radius of curvature that extends fromthe second implant proximal end 130 to the second implant distal end132.

Recess 139 is adapted to receive a portion, or the entirety, of insert106, as described in more detail herein. Recess 139 has a recess length141, recess base 142, recess distal end 143, recess first portion 144,and a recess second portion 146. Recess 139 extends into second implantbody 134 from a side opposably facing second implant surface 138 torecess base 142 and from the second implant proximal end 130 toward thesecond implant distal end 132 to recess distal end 143 disposed betweensecond implant proximal end 130 and second implant distal end 132.Recess length 141 extends from the second implant proximal end 130toward the second implant distal end 132 to recess distal end 143.

Each projection of the plurality of recess projections 140 extends intorecess 139 along a portion, or the entirety, of recess length 141 andhas a tapered edge that is adapted to interact with a portion of insert106 to releasably attach insert 106 to second implant component 104.Recess base 142 is opposably facing, or substantially opposably facing,second implant surface 138, is convex, or substantially convex, and issmooth, substantially smooth, or uninterrupted. Recess base 142 has aradius of curvature that extends from the second implant proximal end130 to recess distal end 143. Recess first portion 144 extends fromrecess base 142 and away from the second implant surface 138 to theplurality of recess projections 140 and has a recess first portion width145 along the second implant proximal end 130. Recess second portion 146extends from the recess first portion 144 and away from the secondimplant surface 138 and has a recess second portion width 147 along thesecond implant proximal end 130 that is measured from a first recessprojection of the plurality of recess projections 140 to a second recessprojection of the plurality of recess projections 140. The recess firstportion width 145 is different than the recess second portion width 147.In the illustrated embodiment, recess first portion width 145 is greaterthan the recess second portion width 147. However, recess first portionwidth 145 can have any suitable width. Example widths consideredsuitable for a recess first portion width include, but are not limitedto, equal to, substantially equal to, greater than, or less than, arecess second portion width.

While second implant surface 138 has been described as concave, orsubstantially concave, and recess base 142 has been described as convex,or substantially convex, the second implant surface and recess base of asecond implant component can have any suitable structural arrangement.Skilled artisans will be able to select a suitable structuralarrangement for the second implant surface and/or recess base of asecond implant component according to a particular embodiment based onvarious considerations, including the structural arrangement at adesired implant site and/or the structural arrangement of the insert ofan implant system. Example structural arrangements considered suitablefor the second implant surface and/or recess base of a second implantcomponent include, but are not limited to, curved, nonuniform, uniform,flat, substantially flat, convex, substantially convex, concave,substantially concave, and any other structural arrangement consideredsuitable for a particular application.

Second implant surface 138 and recess base 142 can have any suitableradius of curvature and second implant component can have any suitabledimensions, and skilled artisans will be able to select a suitableradius of curvature for an implant surface and recess base of a secondimplant component and/or suitable dimensions for a second implantcomponent according to a particular embodiment based on variousconsiderations, including the structural arrangement at a desiredimplant site. For example, one or more second implant components can beprovided in a kit such that one, two, at least two, or a plurality ofthe implant components has/have a different radius of curvature on animplant surface and/or recess base and/or different dimensions. It isconsidered advantageous to provide a variety of differently sized secondimplant components at least because this provides a mechanism formatching a second implant component with the anatomy at an implant site.It is considered advantageous for a second implant component to have athickness that is able to withstand the forces placed on the secondimplant component and/or an implant site (e.g., subtalar joint) duringuse (e.g., walking, running) and prevent, or substantially prevent,fracture of and/or damage to the second implant component.

While second implant surface 138 has been described as having a radiusof curvature that extends from the second implant proximal end 130 tothe second implant distal end 132 and recess base 142 has been describedas having a radius of curvature that extends from the second implantproximal end 130 to recess distal end 143, the second implant body candefine a radius of curvature along any suitable length of a surface.Skilled artisans will be able to select a suitable length to define aradius of curvature on the surface of a second implant componentaccording to a particular embodiment based on various considerations,including the structural configuration at an implant site. Examplelengths considered suitable to define a radius of curvature on thesurface of a an implant component include, but are not limited to, fromthe second implant proximal end to the second implant distal end of asecond implant component, from a location distal to the second implantproximal end to the second implant distal end of a second implantcomponent, between the second implant proximal end and the secondimplant distal end of a second implant component, from the secondimplant proximal end to a location proximal to the second implant distalend of a second implant component, from the second implant proximal endto the recess distal end of a second implant component, from a locationdistal to the second implant proximal end to the recess distal end of asecond implant component, between the second implant proximal end andthe recess distal end of a second implant component, and from the secondimplant proximal end to a location proximal to the recess distal end ofa second implant component.

While second implant surface 138 has been described as smooth,substantially smooth, or uninterrupted, the second implant surface of asecond implant component can comprise any suitable texture, roughness,and/or porosity and skilled artisans will be able to select a suitabletexture, roughness, and/or porosity for the second implant surface of asecond implant component according to a particular embodiment based onvarious considerations, including the desired amount of bone ingrowthdesired between a second implant component and the bone at an implantsite. For example, alternative to second implant surface comprising asmooth, substantially smooth, or uninterrupted surface, the secondimplant surface of a second implant component can comprise a porous, orsubstantially porous, surface. It is considered advantageous for theimplant surface of a second implant component to have a porous, orsubstantially porous, surface to increase the amount of bone ingrowthbetween a second implant component and the bone at an implant site.

While second implant body 134 has been described as defining a recess139 with a recess length 141, recess first portion 144, and a recesssecond portion 146 and defining a plurality of recess projections 140,the body of an implant component can define a recess having any suitablestructural arrangement to provide a mechanism for attaching an insert toan implant component. Skilled artisans will be able to select a suitablestructural arrangement for an implant component and/or recess of animplant component according to a particular embodiment based on variousconsiderations, including the structural arrangement at an implant siteand/or the structural arrangement of the insert of an implant system.For example, the body of an implant component can define a recess havingonly a single portion extending along a recess length that is equal to,or substantially equal to, a portion, or the entirety, of the length ofthe implant component (e.g., recess can extend the entire axial lengthof an implant component from the implant proximal end to the implantdistal end).

While each projection of the plurality of recess projections 140 hasbeen described and illustrated as having a tapered configuration, arecess projection can have any suitable structural configuration, andskilled artisans will be able to select a suitable structuralconfiguration for a recess projection according to a particularembodiment based on various considerations, including the materialforming the insert of an implant system. Example structural arrangementsconsidered suitable for a projection include, but are not limited to,flat, or substantially flat, tapered, curved, serrated, and any otherstructural arrangement considered suitable for a particular application.

In the illustrated embodiment, each projection of the plurality ofsecond implant projections 136 has a second implant projection proximalend 150, second implant projection distal end 152, and extends outwardand away, or radially outward, from second implant surface 138 at a 90degree, or substantially 90 degree, angle from a second implantprojection first end 154 to a second implant projection second end 156.Each projection of the plurality of second implant projections 136 iselongated, is disposed between second implant proximal end 130 andsecond implant distal end 132, and defines a serrated second implantprojection second end 156. It is considered advantageous for eachprojection of the plurality of second implant projections 136 to definea serrated second implant projection second end 156 at least becausethis structural configuration provides a mechanism for increasing theamount of attachment between the second implant component 104 and thesurface at an implant site.

The serrated second implant projection second end 156 of each projectionof the plurality of second implant projections 136 is configured suchthat it has a plurality of projection declining surfaces 157. Eachprojection declining surface of the plurality of projection decliningsurfaces 157 extends from a first end 157′ toward second implant distalend 132 to a second end 157″. The first end 157′ is disposed a firstprojection distance from second implant surface 138 and the second end157″ is disposed a second projection distance from second implantsurface 138. The first projection distance is greater than the secondprojection distance. This configuration is considered advantageous atleast because it provides a mechanism for reducing the complexity ofimplanting second implant component 104 at an implant site while alsopreventing, or substantially preventing, second implant component 104from becoming loose after being implanted. For example, duringimplantation, second implant component 104 can be introduced at inimplant site without the serrated second implant projection second end156 of each projection of the plurality of projections 136 increasingresistance, or substantially increasing resistance. In addition, afterimplantation, the serrated second implant projection second end 156 ofeach projection of the plurality of projections 136 will be forced intothe treatment site upon the application of force on second implant body134 and/or toward second implant proximal end 130.

While each projection of the plurality of second implant projections 136has been illustrated and described as disposed between the secondimplant proximal end 130 and second implant distal end 132, a projectioncan be positioned at any suitable location on an implant component andcan extend any suitable length along the implant surface of the implantcomponent. Skilled artisans will be able to select a suitable locationto position a projection and a suitable length for a projectionaccording to a particular embodiment based on various considerations,including the structural arrangement of the desired implant site.Example positions and lengths considered suitable for a projectioninclude, but are not limited to, a projection that is disposed on theimplant surface of an implant component and extends from the secondimplant proximal end to the second implant distal end, a projection thatis disposed on the implant surface of an implant component and extendsfrom the second implant proximal end to a location proximal to thesecond implant distal end, a projection that is disposed on the implantsurface of an implant component and extends between the second implantproximal end and the second implant distal end, and a projection that isdisposed on the implant surface of an implant component and extends froma location between the second implant proximal end and the secondimplant distal end to the second implant distal end.

While a plurality of second implant projections 136 has been describedand illustrated, any suitable number of projections can be included on asecond implant component, and skilled artisans will be able to select asuitable number of projections for inclusion on a second implantcomponent according to a particular embodiment based on variousconsiderations, including the structural arrangement at a desiredimplant site. Example number of projections considered suitable toinclude on a second implant component include, but are not limited to,one, at least one, two, three, four, five, a plurality, and any othernumber considered suitable for a particular application. If more thanone implant projection is included on a second implant component, theimplant projections can be disposed on a second implant surface in anysuitable structural configuration. For example, the implant projectionscan be disposed linearly between a second implant proximal end and asecond implant distal end and/or staggered between a second implantproximal end and a second implant distal end.

While the second implant projection second end 156 of each projection ofthe plurality of second implant projections 136 has been described andillustrated as serrated, the second implant projection second end of aprojection can have any suitable structural configuration. Skilledartisans will be able to select a suitable structural configuration forthe second implant projection second end of a projection according to aparticular embodiment based on various considerations, including thestructural arrangement of the desired implant site. Example structuralconfigurations considered suitable for the second implant projectionsecond end of a projection include, but are not limited to, tapered,pointed, smooth, substantially smooth, porous, substantially porous,serrated, serrated having one or more identical teeth, serrated having afirst tooth and a second tooth with a different structuralconfiguration, serrated having at least two teeth with differentstructural configurations, serrated having a first set of teeth with afirst configuration and a second set of teeth with a second structuralconfiguration different than the first structural configuration, and anyother structural configuration considered suitable for a particularapplication. For example, a projection declining surface of theplurality of projection declining surfaces 157 and/or any other portionof a second implant projection of the plurality of second implantprojections 136 can include one or more cavities or comprise a porous,or substantially porous, surface to allow for bone ingrowth. Examplestructural configurations for a tooth of a serrated second implantprojection second end include, but are not limited to, triangular,square, circular, curved, and any other structural configurationconsidered suitable for a particular application.

In the illustrated embodiment, a first projection of the plurality offirst implant projections 114 is disposed parallel, or substantiallyparallel, to a second projection of the plurality of first implantprojections 114 and a first projection of the plurality of secondimplant projections 136 is disposed parallel, or substantially parallel,to a second projection of the plurality of second implant projections136. It is considered advantageous to position a first projection of theplurality of first implant projections 114 parallel, or substantiallyparallel, to a second projection of the plurality of first implantprojections 114 and a first projection of the plurality of secondimplant projections 136 parallel, or substantially parallel, to a secondprojection of the plurality of second implant projections 136 at leastbecause this configuration allows for the first implant component 102and/or second implant component 104 to be seated properly at the implantsite and provides a mechanism for reducing the complexity of the implantprocedure during the introduction of the first implant component 102and/or second implant component 104.

While first implant component 102 has been illustrated and described ashaving a first projection of the plurality of first implant projections114 being disposed parallel, or substantially parallel, to a secondprojection of the plurality of first implant projections 114 and secondimplant component 104 has been illustrated and described as having afirst projection of the plurality of second implant projections 136being disposed parallel, or substantially parallel, to a secondprojection of the plurality of first implant projections 136, a firstprojection of a plurality of implant projections can be disposed at anysuitable angle to a second projection of the plurality of implantprojections. Skilled artisans will be able to select a suitable angle toposition a first projection of a plurality of implant projections withrespect to a second projection of the plurality of implant projections,according to a particular embodiment based on various considerations,including the number of projections disposed on a first implantcomponent and/or the structural arrangement at a desired implant site.

While each implant projection of the plurality of first implantprojections 114 has been illustrated and described as extending outwardand away from first implant surface 116 at a 90 degree, or substantially90 degree, angle, and each projection of the plurality of second implantprojections 136 has been illustrated and described as extending outwardand away from second implant surface 138 at a 90 degree, orsubstantially 90 degree, angle, a projection can extend outward and awayfrom an implant surface at any suitable angle and comprise any suitablelength. Skilled artisans will be able to select a suitable angle andlength for a projection to extend outward and away from an implantsurface of an implant component according to a particular embodimentbased on various considerations, including the structural arrangement ata desired implant site. Example angles considered suitable for aprojection to extend outward and away from an implant surface of animplant component include, but are not limited to, a 90 degree angle, asubstantially 90 degree angle, a 45 degree angle, a substantially 45degree angle, an acute angle, an obtuse angle, an angle such that theprojection is normal to the implant surface, an angle such that theprojection is substantially normal to the implant surface, and any otherangle considered suitable for a particular application. It is consideredadvantageous for a projection to extend outward and away from a firstimplant surface and/or second implant surface at least a length thatwill provide resistance to sliding after implantation and reducesinterference during implantation of the component.

Insert 106 can be formed of any suitable material, and skilled artisanswill be able to select a suitable material to form an insert of animplant system according to a particular embodiment based on variousconsiderations, including the material forming a first implant componentand/or second implant component of an implant system. Example materialsconsidered suitable to form an insert include, but are not limited to,biocompatible materials, materials that can be made biocompatible,ceramics, polymers, polyethylene, and ultra-high-molecular-weightpolyethylene (UHMWPE), metals, tantalum, titanium (Ti), and cobaltalloys (e.g., cobalt-chromium (CoCr), cobalt-chromium-molybdenum(CoCrMo)). It is considered advantageous to form insert 106 ofultra-high-molecular-weight polyethylene at least becauseultra-high-molecular-weight polyethylene can be easily machined ormolded into a desired structural arrangement and has increasedwearability and biocompatibility as compared to other materials. Inaddition, ultra-high-molecular-weight polyethylene has decreasedfrictional properties (e.g., lower coefficient of friction) as comparedto other materials and wear particulates are easily phagocytized whencompared to particulates formed from other materials.

In the illustrated embodiment, insert 106 comprises an insert proximalend 160, insert distal end 162, and an insert body 164. Insert 106 isadapted to be releasably attached to the second implant component 104,as described in more detail herein.

Insert body 164 defines an insert base 166, insert articulating portion168, insert recess 170, and an insert shoulder 172. Insert base 166 hasan insert base surface 174 and the insert articulating portion 168 hasan insert articulating surface 176. Insert base surface 174 has a radiusof curvature that extends from insert proximal end 160 to shoulder 172and insert articulating surface 176 has a radius of curvature thatextends from the insert proximal end 160 to the insert distal end 162.Insert base surface 174 is concave, or substantially concave, and isopposably facing, or substantially opposably facing, insert articulatingsurface 176 which is convex, or substantially convex. Insert basesurface 174 is smooth, substantially smooth, or uninterrupted, and iscomplementary to recess base 142 such that insert 106 is slidable alongrecess base 142 and releasable attachment between insert 106 and secondimplant component 104 can be accomplished. Insert articulating surface176 is smooth, substantially smooth, or uninterrupted, and iscomplementary to first articulating surface 118 such that insert 106 canarticulate with first implant component 102. Thus, insert articulatingsurface 176 is adapted to articulate with first articulating surface118.

Insert base 166 has an insert base width 167 along insert proximal end160 and insert articulating portion 168 has an insert articulating width169 along insert proximal end 160. Insert base width 167 is equal to,substantially equal to, less than, or greater than, recess first portionwidth 145. Insert articulating width 169 is equal to, substantiallyequal to, less than, or greater than, recess second portion width 147.It is considered advantageous to include an insert 106 having an insertbase width 167 that is equal to, substantially equal to, or greaterthan, the recess first portion width 145 at least because thisstructural arrangement provides a mechanism for introducing insert base166 into recess first portion 144 and provides a mechanism for achievinga friction fit between insert and second implant component 104. It isconsidered advantageous to include an insert 106 having a insertarticulating width 169 that is equal to, substantially equal to, orgreater than, the recess second portion width 147 at least because thisstructural arrangement provides a mechanism for achieving a friction fitbetween insert 106 and second implant component 104. Thus, each ofinsert base 166 and insert articulating portion 168 is adapted tointeract with recess 139 (e.g., each projection of the plurality ofrecess projections 140) to create a friction fit between insert 106 andsecond implant component 104.

Insert recess 170 extends into insert body 164 from insert distal end162 and toward insert proximal end 160 and from insert base surface 174toward insert articulating surface 176 to define insert shoulder 172.Insert shoulder 172 is disposed between insert proximal end 160 andinsert distal end 162 and is disposed a distance from insert proximalend 160 that is equal to, or substantially equal to, recess length 141.Thus, insert base 166 extends from the insert proximal end 160 towardthe insert distal end 162 to insert shoulder 172 a distance that isequal to, or substantially equal to, recess length 141. Insertarticulating surface 176 extends from insert proximal end 160 to insertdistal end 162. This structural arrangement is considered advantageousat least because insert shoulder 172 provides a mechanical stop todistal axial movement of insert 106 when it is being introduced intorecess 139. It is considered advantageous for insert articulatingsurface 176 to extend from insert proximal end 160 to insert distal end162 at least because this structural arrangement provides additionalstructure distal to insert shoulder 172 and recess 139 when insert 106is releasably attached to second implant component 104, that can beutilized for articulation purposes.

Each of FIGS. 5 and 6 illustrates an exploded view of implant system 100and the relationship between the first implant component 102, secondimplant component 104, and insert 106. In use, each of the first implantcomponent 102 and second implant component 104 is adapted to be attachedat a treatment site such that first articulating surface 118 and recess139 (e.g., recess base 142) are facing, or substantially facing, eachother. Insert 106 is releasably attached to the second implant component104 by sliding insert base 166 into recess first portion 144 andapplying a distally directed axial movement on insert 106 until insertshoulder 172, which is adapted to interact with recess distal end 143,contacts recess distal end 143 and prevents additional distal axialmovement of insert 106. Insert articulating surface 176 is adapted toarticulate with first articulating surface 118 to provide a range ofmovement between the insert 106 and first implant component 102.

While insert 106 has been illustrated and described as being releasablyattached to an implant component that is attached to the calcaneus, theinsert of an implant system can alternatively be attached to an implantcomponent that is attached to the talus such that articulation betweenthe insert and an implant component attached to the calcaneus can beaccomplished, as described in more detail herein.

While insert 106 has been described as being releasably attached tosecond implant component 104 via friction fit between second implantcomponent 104 and insert 106, any suitable method of attachment betweenan insert and an implant component can be used. Skilled artisans will beable to select a suitable method of attachment between an insert and animplant component according to a particular embodiment based on variousconsiderations, including the materials forming the insert and/orimplant component. Example methods of attachment considered suitablebetween an insert and an implant component include, but are not limitedto, using an adhesive, welding, providing a permanent attachment,releasable attachment, fixed attachment, and any other method ofattachment considered suitable for a particular application. Forexample, an insert can be deformed to form to the structural arrangementof an implant component and permanently attached to the implantcomponent. In an additional example, a metal tab can be provided overthe insert articulating surface and a fastener (e.g., screw) can beintroduced through the tab and the insert to prevent, or substantiallyprevent, the insert from becoming free of an implant component afterimplantation. In yet another example, an insert can be attached to animplant component using a fastener (e.g., screw) that passes through aportion, or the entirety, of the insert and the implant component, andoptionally to the implant site. Subsequent to implantation, a firstinsert is adapted to be exchanged with a second insert by removing thefirst insert and introducing the second insert, as described herein.

While insert 106 has been described as having a particular structuralarrangement, the insert of an implant system can have any suitablestructural arrangement that accomplishes attachment between the insertand a first implant component and provides articulation between theinsert and a second implant component. Skilled artisans will be able toselect a suitable structural arrangement for the insert of an implantsystem according to a particular embodiment based on variousconsiderations, including the structural arrangement of a first implantcomponent and/or second implant component. For example, an insert can beadapted to extend the entire length of an implant component from theimplant component proximal end to the implant component distal end.

Insert base surface 174 and insert articulating surface 176 can have anysuitable radius of curvature and insert 106 can have any suitabledimensions, and skilled artisans will be able to select a suitableradius of curvature for a base surface and insert articulating surfaceof an insert and/or suitable dimensions for an insert according to aparticular embodiment based on various considerations, including thestructural arrangement at a desired implant site. For example, one ormore inserts can be provided in a kit such that one, two, at least two,or a plurality of the inserts has/have a different radius of curvatureon a base surface and/or an insert articulating surface and/or differentdimensions. It is considered advantageous to provide a variety ofdifferently sized inserts at least because this provides a mechanism formatching an insert with the anatomy of an implant site, a first implantcomponent, and/or second implant component.

While the insert base surface 174 has been described as having a radiusof curvature that extends from insert proximal end 160 toward the insertdistal end 162 to insert shoulder 172 and insert articulating surface176 has been described as having a radius of curvature that extends frominsert proximal end 160 to insert distal end 162, an insert body candefine a radius of curvature along any suitable length of the surface ofan insert. Skilled artisans will be able to select a suitable length todefine a radius of curvature on the surface of an insert according to aparticular embodiment based on various considerations, including thestructural configuration of an implant component. Example lengthsconsidered suitable to define a radius of curvature on the surface of aninsert include, but are not limited to, from the insert proximal end tothe insert distal end, from a location distal to the insert proximal endto the insert distal end, between the insert proximal end and the insertdistal end, and from the insert proximal end to a location proximal tothe insert distal end.

Implant system 100 can be utilized in any suitable manner and in anysuitable location in a body. For example, implant system 100 can beutilized in subtalar joint arthroplasty, such as to modify the posteriorfacet of the subtalar joint, as illustrated in FIG. 3. Implant system100 can be implanted using any suitable method and/or approach. Whenmodifying the posterior facet of the subtalar joint, it is consideredadvantageous to introduce implant system 100 using a lateral andposterior approach at least because this approach provides access to thejoint and has limited, or reduced, exposure to vital structures ascompared to a medial approach.

Alternative to first implant component 102 being adapted to be attachedto the talus 12 and second implant component 104 being adapted to beattached to the calcaneus 14, a first implant component and/or secondimplant component of an implant system, such as those described herein,can be attached to a talus, navicular, and/or cuboid. Skilled artisanswill be able to select a suitable implant component to attach to atalus, navicular, and/or cuboid according to a particular embodimentbased on various considerations, including the structural arrangement ata treatment site. Example joints considered suitable to utilize animplant system and/or implant method described herein include, but arenot limited to, the subtalar joint, the talonavicular joint, and thecalcaneocuboid joint.

Alternative to including an insert 106, an implant system can omit theinclusion of an insert and a first implant component can articulate witha second implant component. For example, when a first implant componentand a second implant component are each formed of a metal or ceramic,the first implant component can articulate with the second implantcomponent. This can be accomplished by omitting the structure on thefirst implant component and/or second implant component that isconfigured to receive a portion, or the entirety, of an insert (e.g.,recess 139).

FIGS. 7, 8, 9, and 10 illustrate a second exemplary surgical implantsystem 200. Implant system 200 is similar to implant system 100illustrated in FIGS. 3, 4, 5, and 6, and described above, except asdetailed below. Reference numbers in FIGS. 7, 8, 9, and 10 refer to thesame structural element or feature referenced by the same number inFIGS. 3, 4, 5, and 6, offset by 100. Thus, implant system 200 comprisesa first implant component 202, a second implant component 204, and aninsert 206.

In the illustrated embodiment, first implant component 202 includes aplurality of first implant projections 214, a first implant tab 277, anda plurality of fasteners 278. Each projection of the plurality of firstimplant projections 214 extends outward and away from the first implantsurface 216 from a first implant projection first end 224 to a firstimplant projection second end 226. Alternative to elongate projections114 as illustrated in FIGS. 3, 4, 5, and 6, each projection of theplurality of projections 214 and has a circular, or substantiallycircular, cross section along its length from the first implantprojection first end 224 to the first implant projection second end 226and extends from the first implant surface 216 at an angle. In addition,each projection of the plurality of first implant projections 214defines a first implant projection second end 226 that is pointed.

First implant tab 277 comprises a first implant tab wall 279 thatdefines a plurality of first implant bores 280. First implant tab 277extends outward and away from first implant surface 216 at an angle andalong a portion of first implant proximal end 208. Each bore of theplurality of first implant bores 280 extends through the first implanttab wall 279 from the first implant proximal end 208 toward the firstimplant distal end 210 at an acute angle to first implant surface 216and is adapted to receive a portion of a fastener of the plurality offasteners 278. Optionally, each bore of the plurality of first implantbores 280, or a portion thereof, can be countersunk or counterbored toallow a fastener to sit flush with, or below, the outer surface of firstimplant tab 277.

Each fastener of the plurality of fasteners 278 has a fastener first end281 that is adapted to receive a tool used to install the fastener at animplant site and a fastener second end 282 that is threaded and adaptedto be received by a pre-drilled bore at the implant site. Each fastenerof the plurality of fasteners 278 is adapted to attach, or assist withattaching, an implant component at an implant site. Thus, a firstfastener is disposed through a first bore defined by first implant tabwall 279 and a second fastener is disposed through a second bore definedby first implant tab wall 279. A fastener can be disposed through eachbore defined by a first implant tab wall.

While first implant tab 277 has been illustrated and described asextending outward and away from first implant surface 216 and along aportion of first implant proximal end 208, the tab of an implantcomponent can extend from any suitable portion of an implant componentand along any suitable length of an implant component. Skilled artisanswill be able to select a suitable location to position a tab and asuitable length for a tab according to a particular embodiment based onvarious considerations, including the structural arrangement at adesired implant component. Example locations considered suitable toposition a tab include, but are not limited to, along the first implantproximal end of a first implant component, and on the first implantsurface of a first implant component. Example lengths consideredsuitable for a tab include, but are not limited to, a length equal to,or substantially equal to, the length of the first implant proximal endof a first implant component, a length that is less than the length ofthe first implant proximal end of a first implant component, and alength that is greater than the length of the first implant proximal endof a first implant component.

While each bore of the plurality of first implant bores 280 has beenillustrated and described as extending through the first implant tabwall 279 from the first implant proximal end 208 toward the firstimplant distal end 210 at an acute angle to first implant surface 216, abore of a first implant component can extend at any suitable angle tothe first implant surface of a first implant component. Skilled artisanswill be able to select a suitable angle to define a bore according to aparticular embodiment based on various considerations, including thestructural arrangement of an implant site. Example angles consideredsuitable to define a bore on the tab of a first implant componentinclude, but are not limited to, at an angle that is acute to the firstimplant surface of a first implant component, at an angle that is obtuseto the first implant surface of a first implant component, and defininga bore such that it extends parallel, or substantially parallel, to thefirst implant surface of the a implant component.

While a plurality of first implant bores 280 has been illustrated anddescribed, the wall of a tab can define any suitable number of boreshaving any suitable diameter, and skilled artisans will be able toselect a suitable number of bores for inclusion in a tab and a suitablediameter for each bore according to a particular embodiment based onvarious considerations, including the structural configuration at animplant site. Example number of bores considered suitable include, butare not limited to, one, at least one, two, three, four, a plurality,and any other number considered suitable for a particular application.An example diameter considered suitable for a bore includes, but is notlimited to, a diameter that is capable of receiving a fastener.

In the illustrated embodiment, second implant component 204 includes aplurality of second implant projections 236, a second implant tab 283,and a plurality of fasteners 278. Each projection of the plurality ofsecond implant projections 236 extends outward and away from the secondimplant surface 238 from a second implant projection first end 254 to asecond implant projection second end 256. Alternative to elongateprojections 136 as illustrated in FIGS. 3, 4, 5, and 6, each projectionof the plurality of second implant projections 236 has a circular, orsubstantially circular, cross section along its length from the secondimplant projection first end 254 to the second implant projection secondend 256 and extends from the second implant surface 238 at an angle. Inaddition, each projection of the plurality of second implant projections236 defines a second implant projection second end 256 that is pointed.

Second implant tab 283 comprises a second implant tab wall 284 thatdefines a plurality of second implant bores 285. Second implant tab 283extends outward and away from the second implant surface 238 away fromsecond implant distal end 232 at an obtuse, or substantially obtuse,angle and along a portion of second implant proximal end 230. Each boreof the plurality of second implant bores 285 extends through the secondimplant tab wall 284 from the second implant proximal end 230 toward thesecond implant distal end 232 at an acute angle to second implantsurface 238 and is adapted to receive a portion of a fastener of theplurality of fasteners 278. Optionally, each bore of the plurality ofsecond implant bores 285, or a portion thereof, can be countersunk orcounterbored to allow a fastener to sit flush with, or below, the outersurface of second implant tab 283. A first fastener is disposed througha first bore defined by second implant tab wall 284 and a secondfastener is disposed through a second bore defined by second implant tabwall 284. A fastener can be disposed through each bore defined by asecond implant tab wall.

In the illustrated embodiment, each bore of the plurality of firstimplant bores 280 and each bore of the plurality of second implant bores285 has a bore axis that extends through its center. Each bore axis ofthe plurality of first implant bores 280 is disposed on a first planeand each bore axis of the plurality of second implant bores 285 isdisposed on a second plane that intersects the first plane at an angle.The first plane and second plane can intersect at any suitable angle,and skilled artisans will be able to select a suitable angle for a firstplane and a second plane to intersect according to a particularembodiment based on various considerations, including the structuralarrangement at a treatment site. Example angles considered suitable fora first plane and a second plane to intersect include, but are notlimited to, an angle between about 1 degree and 90 degrees, an anglebetween about 90 degrees and about 180 degrees, a 90 degree angle, asubstantially 90 degree angle, a 45 degree angle, a substantially 45degree angle, an acute angle, an obtuse angle, and any other angleconsidered suitable for a particular application. Alternatively, a firstplane that contains each bore axis of a plurality of first implant borescan extend parallel, or substantially parallel, to a second plane thatcontains each bore axis of a plurality of second implant bores.

While second implant tab 283 has been illustrated and described asextending outward and away from second implant surface 238 and along aportion of second implant proximal end 230, the tab of an implantcomponent can extend from any suitable portion of an implant componentand along any suitable length of an implant component. Skilled artisanswill be able to select a suitable location to position a tab and asuitable length for a tab according to a particular embodiment based onvarious considerations, including the structural arrangement at adesired implant site. Example locations considered suitable to positiona tab include, but are not limited to, along the second implant proximalend of a second implant component, and on the second implant surface ofa second implant component. Example lengths considered suitable for atab include, but are not limited to, a length equal to, or substantiallyequal to, the length of the second implant proximal end of a secondimplant component, a length that is less than the length of the secondimplant proximal end of a second implant component, and a length that isgreater than the length of the second implant proximal end of a secondimplant component.

While each bore of the plurality of second implant bores 285 has beenillustrated and described as extending through the second implant tabwall 284 from the second implant proximal end 230 toward the secondimplant distal end 232 at an acute angle to second implant surface 238,a bore of a second implant component can extend at any suitable angle toan implant surface of the second implant component. Skilled artisanswill be able to select a suitable angle to define a bore according to aparticular embodiment based on various considerations, including thestructural arrangement at an implant site. Example angles consideredsuitable to define a bore on a second implant component include, but arenot limited to, at an angle that is acute to the second implant surfaceof a second implant component, at an angle that is obtuse to the secondimplant surface of a second implant component, and defining a bore suchthat it extends parallel, or substantially parallel, to the secondimplant surface of a second implant component.

While a plurality of second implant bores 285 have been illustrated anddescribed, the wall of a tab can define any suitable number of boreshaving any suitable diameter, and skilled artisans will be able toselect a suitable number of bores for inclusion in a tab and a suitablediameter for each bore according to a particular embodiment based onvarious considerations, including the structural configuration at animplant site. Example number of bores considered suitable include, butare not limited to, one, at least one, two, three, four, a plurality,and any other number considered suitable for a particular application.An example diameter considered suitable for a bore includes, but is notlimited to, a diameter that is capable of receiving a fastener.

While a plurality of fasteners 278 have been illustrated and describedas providing a secondary method of attachment between the first implantcomponent 202 and the surface at an implant site and/or the secondimplant component 204 and the surface at an implant site, any suitablenumber of fasteners and/or any suitable method of attachment can be usedto attach an implant component at a desired treatment site. Skilledartisans will be able to select a suitable number of fasteners and/or asuitable method of attachment according to a particular embodiment basedon various considerations, including the structural configuration at adesired implant site. Example number of fasteners considered suitableinclude, but are not limited to, one, at least one, two, three, four,five, six, a plurality, and any other number considered suitable for aparticular application. The number of fasteners included can be based onthe number of bores defined by a first implant component and/or a secondimplant component. Example methods of attachment considered suitablebetween a first implant component and/or a second implant component andthe surface at a desired treatment site include, but are not limited to,using an adhesive, plugs, screws, compression screws, locking screws,multi-angle screw, cortical screw, cancellous screw, and any othermethod of attachment considered suitable for a particular application.

Each projection of the plurality of first implant projections 214 andeach projection of the plurality of second implant projections 236 canextend outward and away from an implant surface of an implant componentat any suitable angle and have any suitable length. Skilled artisanswill be able to select a suitable angle and length for a projection toextend outward and away from an implant surface of an implant componentaccording to a particular embodiment based on various considerations,including the structural arrangement at a desired implant site. Exampleangles considered suitable for a projection to extend outward and awayfrom an implant surface of an implant component include, but are notlimited to, a 90 degree angle, a substantially 90 degree angle, a 45degree angle, a substantially 45 degree angle, an angle less than 45degrees, an acute angle, an obtuse angle, an angle such that theprojection is normal to the implant surface, an angle such that theprojection is substantially normal to the implant surface, and any otherangle considered suitable for a particular application. It is consideredadvantageous for a projection to extend outward and away from a firstimplant surface and/or second implant surface at least a length thatwill provide resistance to sliding after implantation and reducesinterference during implantation of the component.

While first implant tab 277 has been illustrated and described asextending outward and away from the first implant surface 216 at anangle and second implant tab 283 has been illustrated and described asextending outward and away from second implant surface 238 at an obtuse,or substantially obtuse, angle, an implant tab can extend outward andaway from an implant surface of an implant component at any suitableangle and have any suitable length. Skilled artisans will be able toselect a suitable angle and length for an implant tab to extend from animplant surface of an implant component according to a particularembodiment based on various considerations, including the structuralarrangement of a desired implant site. Example angles consideredsuitable for a tab to extend outward and away from an implant surface ofan implant component include, but are not limited to, a 90 degree angle,a substantially 90 degree angle, an acute angle, an obtuse angle, anangle such that the tab is normal to the first implant surface, an anglesuch that the tab is substantially normal to the first implant surface,and any other angle considered suitable for a particular application. Itis considered advantageous to for first implant tab and/or secondimplant tab to be dimensioned such that it is adapted to accept thefastener first end of a fastener, or a plurality of fasteners, andprovide material around the fastener first end of each fastener at leastto prevent fatigue and/or failure.

Each bore of the plurality of first implant bores 280 and/or each boreof the plurality of second implant bores 285 can optionally be adaptedto receive a multi-angle screw that can include a locking cap onfastener first end 281. Using a multi-angle screw is consideredadvantageous at least because it provides a mechanism directing thefastener to a desired location at the treatment site. For example, suchthat distal cortical fixation can be achieved.

FIGS. 11, 12, 13, and 14 illustrate a third exemplary surgical implantsystem 300. Implant system 300 is similar to implant system 200illustrated in FIGS. 7, 8, 9, and 10, and described above, except asdetailed below. Reference numbers in FIGS. 11, 12, 13, and 14 refer tothe same structural element or feature referenced by the same number inFIGS. 7, 8, 9, and 10, offset by 100. Thus, implant system 300 comprisesa first implant component 302, a second implant component 304, and aninsert 306.

In the illustrated embodiment, second implant component 304 omits theinclusion of a second implant tab, as illustrated and described withrespect to FIGS. 7, 8, 9, and 10, and includes a plurality of secondimplant projections 336 and second implant body 334 defines a pluralityof second implant protuberances 386.

Each projection of the plurality of second implant projections 336extends outward and away from the second implant surface 338 from asecond implant projection first end 354 toward the second implant distalend 332 to a second implant projection second end 356 at an acute anglewith respect to implant surface 338. This configuration advantageouslyallows for placement and implantation of second implant component 304 ata distance from an implant surface that is less than that required whena second implant component includes projections that extend at a 90degree, or substantially 90 degree, angle and have the same length asthe plurality of second implant projections 336 (e.g., second implantcomponent 204). Thus, it is considered advantageous to include aplurality of second implant projections 336 that extend at an angle withrespect to second implant surface 338 at least to allow second implantcomponent 304 to be implanted at an angle and to reduce the distancerequired between the second implant component 304 and an implant surfacewhile second implant component 304 is being introduced.

Second implant body 334 defines the plurality of second implantprotuberances 386 between the second implant proximal end 330 and thesecond implant distal end 332. Each protuberance of the plurality ofsecond implant protuberances 386 extends outward and away from thesecond implant surface 338 toward the second implant distal end 332 froma protuberance first end 387 to a protuberance second end 388. Eachprotuberance of the plurality of second implant protuberances 386extends at an acute, or substantially acute, angle with respect tosecond implant surface 338. The second implant body 334 defines apassageway 389 through each protuberance of the plurality of secondimplant protuberances 386 that extends from a first opening defined onrecess base 342 to second opening defined on protuberance second end388. Each passageway 389 provides access for passing a portion of afastener of the plurality of fasteners 378 through a protuberance of theplurality of second implant protuberances 386 to attach, or assist withattaching, second implant component 304 at an implant site. Optionally,each passageway 389 defined by second implant body 334, or a portionthereof, can be countersunk or counterbored to allow a fastener to sitflush with, or below, the outer surface of recess base 342. Thus, afirst fastener is disposed through a first passageway defined by secondimplant body 334 and a second fastener is disposed through a secondpassageway defined by second implant body 334. A fastener can bedisposed through each passageway defined by a second implant body.

In the illustrated embodiment, each bore of the plurality of firstimplant bores 380 has a bore axis that extends through its center andeach passageway 389 defined by second implant body 334 has a passagewayaxis that extends through its center. Each bore axis of the plurality offirst implant bores 380 is disposed on a first plane and each passagewayaxis of each passageway 389 defined by second implant body 334 isdisposed on a second plane that intersects the first plane at an angle.The first plane and second plane can intersect at any suitable angle,and skilled artisans will be able to select a suitable angle for a firstplane and a second plane to intersect according to a particularembodiment based on various considerations, including the structuralarrangement at a treatment site. Example angles considered suitable fora first plane and a second plane to intersect include, but are notlimited to, an angle between about 1 degree and 90 degrees, an anglebetween about 90 degrees and about 180 degrees, a 90 degree angle, asubstantially 90 degree angle, a 45 degree angle, a substantially 45degree angle, an acute angle, an obtuse angle, and any other angleconsidered suitable for a particular application. Alternatively, a firstplane that contains each bore axis of a plurality of first implant borescan extend parallel, or substantially parallel, to a second plane thatcontains each passageway axis of each passageway defined by a secondimplant body.

While a plurality of second implant protuberances 386 have beenillustrated and described, the body of an implant component can defineany suitable number of protuberances, and skilled artisans will be ableto select a suitable number of protuberances for inclusion in an implantcomponent according to a particular embodiment based on variousconsiderations, including the structural configuration at an implantsite. Example number of protuberances considered suitable include toinclude in an implant component include, but are not limited to, one, atleast one, two, three, four, a plurality, and any other numberconsidered suitable for a particular application.

While each protuberance of the plurality of second implant protuberances386 has been illustrated and described as extending at an acute anglewith respect to second implant surface 338, a protuberance of an implantcomponent can extend at any suitable angle to the implant surface of theimplant component. Skilled artisans will be able to select a suitableangle to define a protuberance according to a particular embodimentbased on various considerations, including the structural arrangement atan implant site. Example angles considered suitable to define aprotuberance on an implant component include, but are not limited to, anangle that is acute to the implant surface of an implant component, anangle that is obtuse to the implant surface of an implant component, anddefining a protuberance such that it extends at a 90 degree, orsubstantially 90 degree, angle to the implant surface of an implantcomponent.

FIGS. 15, 16, 17, and 18 illustrate a fourth exemplary surgical implantsystem 400. The implant system 400 is similar to implant system 300illustrated in FIGS. 11, 12, 13, and 14, and described above, except asdetailed below. Reference numbers in FIGS. 15, 16, 17, and 18 refer tothe same structural element or feature referenced by the same number inFIGS. 11, 12, 13, and 14, offset by 100. Thus, implant system 400comprises a first implant component 402, a second implant component 404,and an insert 406.

In the illustrated embodiment, the first implant component 402 omits theinclusion of a first implant tab, as illustrated and described withrespect to FIGS. 11, 12, 13, and 14, and includes a plurality of firstimplant projections 414 and a porous first implant surface 416. It isconsidered advantageous for first implant component 402 to have aporous, or substantially porous, first implant surface 416 at leastbecause this type of surface increases the amount of bone ingrowthbetween first implant component 402 and the bone at an implant site. Thestructural configuration of first implant component 402 (e.g., omittingthe inclusion of a first implant tab) is considered advantageous atleast because it reduces the overall size of first implant component 402and reduces the complexity of implanting first implant component 402 ata treatment site.

FIGS. 19, 20, 21, and 22 illustrate a fifth exemplary surgical implantsystem 500. The implant system 500 is similar to implant system 400illustrated in FIGS. 15, 16, 17, and 18, and described above, except asdetailed below. Reference numbers in FIGS. 19, 20, 21, and 22 refer tothe same structural element or feature referenced by the same number inFIGS. 15, 16, 17, and 18, offset by 100. Thus, implant system 500comprises a first implant component 502, a second implant component 504,and an insert 506.

In the illustrated embodiment, first implant component 502 omits theinclusion of the plurality of first implant projections and alternativeto having a first implant surface that is convex, or substantiallyconvex, first implant body 512 defines a flat, or substantially flat,first implant surface 516 and an opposably facing concave, orsubstantially concave, first articulating surface 518. In addition,first implant body 512 defines a plurality of first implant bores 590.Each bore of the plurality of first implant bores 590 extends from afirst opening defined on first implant proximal end 508 to a secondopening defined on first implant surface 516. Each bore of the pluralityof first implant bores 590 provides access for a fastener of theplurality of fasteners 578, such that attachment between first implantcomponent 502 at an implant site can be accomplished. Optionally, eachbore of the plurality of first implant bores 590, or a portion thereof,can be countersunk or counterbored to allow a fastener to sit flushwith, or below, the outer surface of first implant 502. Thus, a firstfastener is disposed through a first bore defined by first implant body512 and a second fastener is disposed through a second bore defined byfirst implant body 512. A fastener can be disposed through each boredefined by a first implant body.

In the illustrated embodiment, and alternative to having a secondimplant surface that is concave, or substantially concave, and a recessbase that is convex, or substantially convex, second implant body 534defines a flat, or substantially flat, second implant surface 538, arecess 539 that has a flat, or substantially flat, recess base 542, anda plurality of recess protuberances 591. In addition, alternative tosecond implant body defining a plurality of recess projections, secondimplant body 534 defines a ridge 592 that extends into recess 539. Thus,second implant component 504 comprises a second implant proximal end530, second implant distal end 532, and a second implant body 534.Second implant body 534 defines recess 539 that extends into secondimplant body 534 from the second implant proximal end 530 toward thesecond implant distal end 532 and a ridge 592 that extends into recess539.

Each protuberance of the plurality of recess protuberances 591 isdisposed along the recess length 541 of recess first portion 544 betweenthe second implant proximal end 530 an recess distal end 543 and extendsinto recess first portion 544. Each protuberance of the plurality ofprotuberances 591 tapers from the distal end of the protuberance to theproximal end of the protuberance. A first protuberance of the pluralityof protuberances 591 is disposed on a first recess side 593 and a secondprotuberance of the plurality of protuberances 591 is disposed on asecond recess side 594. The first recess side 593 is opposite, orsubstantially opposite, the second recess side 594 across recess 539.Each of the first recess side 593 and second recess side 594 extendsfrom the second implant proximal end 530 to the recess distal end 543.

Recess first portion 544 extends from recess base 542 to ridge 592 andhas a recess first portion width 545 along the second implant proximalend 530. Recess second portion 546 has a recess second portion width 547along the second implant proximal end 530 that is different than recessfirst portion width 545. In the illustrated embodiment, recess secondportion width 547 is less than recess first portion width 545 an amountthat is equal to, or substantially equal to, the distance ridge 592extends into recess 539 on first recess side 593 and second recess side594.

Ridge 592 extends into recess 539 about the entirety, or a portion of,the perimeter of recess 539. Thus, ridge 592 extends into recess 539along the first recess side 593, second recess side 594, and recessdistal end 543. The structural arrangement of second implant body 534and recess 539 is considered advantageous at least because it provides amechanism for releasably attaching an insert, such as insert 506, tosecond implant component 504.

In the illustrated embodiment, each bore of the plurality of firstimplant bores 590 has a bore axis that extends through its center andeach passageway 589 defined by second implant body 534 has a passagewayaxis that extends through its center. Each bore axis of the plurality offirst implant bores 590 is disposed on a first plane and each passagewayaxis of each passageway 589 defined by second implant body 534 isdisposed on a second plane that intersects the first plane at an angle.The first plane and second plane can intersect at any suitable angle,and skilled artisans will be able to select a suitable angle for a firstplane and a second plane to intersect according to a particularembodiment based on various considerations, including the structuralarrangement at a treatment site. Example angles considered suitable fora first plane and a second plane to intersect include, but are notlimited to, an angle between about 1 degree and 90 degrees, an anglebetween about 90 degrees and about 180 degrees, a 90 degree angle, asubstantially 90 degree angle, a 45 degree angle, a substantially 45degree angle, an acute angle, an obtuse angle, and any other angleconsidered suitable for a particular application. Alternatively, a firstplane that contains each bore axis of a plurality of first implant borescan extend parallel, or substantially parallel, to a second plane thatcontains each passageway axis of each passageway defined by a secondimplant body.

While each protuberance of the plurality of protuberances 591 has beendescribed and illustrated as having a tapered configuration and as beingpositioned in the recess first portion 544, a protuberance can have anysuitable structural configuration and be positioned at any suitablelocation on an implant component. Skilled artisans will be able toselect a suitable structural configuration for a protuberance and asuitable location to position a protuberance on an implant componentaccording to a particular embodiment based on various considerations,including the material forming an insert and/or implant component.Example locations considered suitable to position a protuberance on animplant component include, but are not limited to, along a portion, orthe entirety, of the recess first portion of an implant component, alonga portion, or the entirety, of the recess second portion of an implantcomponent, and along a portion, or the entirety, of the recess base ofan implant component.

In the illustrated embodiment, and alternative to having an insert basesurface that is concave, or substantially concave, insert body 564defines an insert base surface 574 that is flat, or substantially flat,and that is complementary to recess base 542. In addition, insert body564 defines a plurality of first insert recesses 595 and second insertrecess 596. A first recess of the plurality of first insert recesses 595extends into insert base 566 on an insert first side 597 and a secondrecess of the plurality of insert recesses 595 extends into insert base566 on an insert second side 598. Each recess of the plurality of insertrecesses 595 is disposed between the insert proximal end 560 and insertdistal end 562 and tapers from the distal end of the recess to theproximal end of the recess. Each recess of the plurality of insertrecesses 595 is complementary to a protuberance of the plurality ofrecess protuberances 591. This configuration is considered advantageousat least because it provides a mechanism for releasably attaching insert506 to second implant component 504.

In addition to defining shoulder 570, insert body 564 defines secondinsert recess 596 between insert base 566 and insert articulatingsurface 576. Second insert recess 596 extends along the entirety, or aportion of, insert distal end 562 and complements ridge 592 along therecess distal end 543. Second insert recess 596 extends into insert body564 a distance that is equal to, or substantially equal to, less than,or greater than, the distance that ridge 592 extends into recess 539.Thus, second insert recess 596 is adapted to interact with ridge 592 ofrecess 539.

In use, as shown in FIG. 19, as distally directed axial movement isplaced on insert 506, shown as arrow 599, insert base 566 is insertedinto recess first portion 544. As distally directed axial movementcontinues to be placed on insert 506, a first protuberance of theplurality of protuberances 591 will engage with a first recess of theplurality of first insert recesses 595 to attach insert 506 to secondimplant component 504.

FIGS. 23, 24, and 25 illustrate a sixth exemplary surgical implantsystem 600. The implant system 600 is similar to implant system 500illustrated in FIGS. 19, 20, 21, and 22, and described above, except asdetailed below. Reference numbers in FIGS. 23, 24, and 25 refer to thesame structural element or feature referenced by the same number inFIGS. 19, 20, 21, and 22, offset by 100. Thus, implant system 600comprises a first implant component 602, a second implant component 604,and an insert 606.

Alternative to introducing an implant system using a lateral andposterior approach, as described above, the illustrated embodimentprovides an implant system 600 that can be introduced into a body usinga medial and posterior approach.

In the illustrated embodiment, alternative to first implant bodydefining a first articulating surface that extends from the firstimplant proximal end to the first implant distal end, first implant body612 defines a first articulating surface 618 that extends from a firstimplant first side 700 to a first implant second side 702. Each of thefirst implant first side 700 and first implant second side 702 extendsfrom first implant proximal end 608 to first implant distal end 610.

In the illustrated embodiment, alternative to first implant bodydefining a plurality of bores that extend through the first implantproximal end and through the first implant surface, first implant body612 defines a plurality of first implant protuberances 704. Eachprotuberance of the plurality of first implant protuberances 704 extendsoutward and away from the first implant surface 616 from a protuberancefirst end 706 toward first implant distal end 610 to a protuberancesecond end 708 at an acute, or substantially acute, angle with respectto first implant surface 616. The first implant body 612 defines apassageway 710 through each protuberance of the plurality of firstimplant protuberances 704 and that extends from a first opening definedon the first implant proximal end 608 to a second opening defined on theprotuberance second end 708. Each passageway 710 provides access forpassing a fastener of the plurality of fasteners 678 through aprotuberance of the plurality of protuberances 704 to attach, or assistwith attaching, first implant component 602 at an implant site.Optionally, each passageway 710 defined by first implant body 612, or aportion thereof, can be countersunk or counterbored to allow a fastenerto sit flush with, or below, the outer surface of first implant 602.Thus, a first fastener is disposed through a first passageway defined byfirst implant body 612 and a second fastener is disposed through asecond passageway defined by first implant body 612. A fastener can bedisposed through each passageway defined by a first implant body.

In the illustrated embodiment, second implant component 604 comprises asecond implant proximal end 630, second implant distal end 632, and asecond implant body 634. Second implant body 634 defines recess 639 thatextends into second implant body 634 from the second implant proximalend 630 toward the second implant distal end 632 and a ridge 692 thatextends into recess 639.

In the illustrated embodiment, each passageway 710 defined by firstimplant body 612 has a passageway axis that extends through its centerand each passageway 689 defined by second implant body 634 has apassageway axis that extends through its center. Each passageway axis ofeach passageway 710 defined by first implant body 612 is disposed on afirst plane and each passageway axis of each passageway 689 defined bysecond implant body 634 is disposed on a second plane that intersectsthe first plane at an angle. The first plane and second plane canintersect at any suitable angle, and skilled artisans will be able toselect a suitable angle for a first plane and a second plane tointersect according to a particular embodiment based on variousconsiderations, including the structural arrangement at a treatmentsite. Example angles considered suitable for a first plane and a secondplane to intersect include, but are not limited to, an angle betweenabout 1 degree and 90 degrees, an angle between about 90 degrees andabout 180 degrees, a 90 degree angle, a substantially 90 degree angle, a45 degree angle, a substantially 45 degree angle, an acute angle, anobtuse angle, and any other angle considered suitable for a particularapplication. Alternatively, a first plane that contains each passagewayaxis of each passageway defined by a first implant component can extendparallel, or substantially parallel, to a second plane that containseach passageway axis of each passageway defined by a second implantcomponent.

In the illustrated embodiment, insert 606 comprises an insert proximalend 660, insert distal end 662, and an insert body 664. Alternative toinsert body defining an insert articulating surface that has radius ofcurvature that extends from the insert proximal end to the insert distalend (e.g., FIG. 19, FIG. 20), insert body 664 defines an insertarticulating surface 676 that has a radius of curvature that extendsfrom insert first side 697 to insert second side 698.

In addition, insert body 664 defines second insert recess 696 betweeninsert base 666 and insert articulating surface 676. Second insertrecess 696 extends along insert first side 697, insert second side 698,and insert distal end 662. Second insert recess 696 extends into insertbody 664 a distance that is equal to, or substantially equal to, lessthan, or greater than, the distance that ridge 692 extends into recess639. Insert base width 667 is equal to, substantially equal to, lessthan, or greater than, recess first portion width 645. Insertarticulating width 669 is greater than insert base width 667.

While insert articulating width 669 has been described and illustratedas being greater than insert base width 667, the insert articulatingportion of an insert can have any suitable width. Skilled artisans willbe able to select a suitable width for the articulating portion of aninsert according to a particular embodiment based on variousconsiderations, including the structural arrangement at an implant site.Example widths considered suitable include, but are not limited to, anarticulating portion that has a width greater than the width of a baseportion of an insert, an articulating portion that has a width less thanthe width of a base portion of an insert, and an articulating portionthat has a width equal to, or substantially equal to, than the width ofa base portion of an insert.

FIGS. 26, 27, 28, and 29 illustrate a seventh exemplary surgical implantsystem 800. The implant system 800 is similar to implant system 500illustrated in FIGS. 19, 20, 21, and 22, and described above, except asdetailed below. Reference numbers in FIGS. 26, 27, 28, and 29 refer tothe same structural element or feature referenced by the same number inFIGS. 19, 20, 21, and 22, offset by 300. Thus, implant system 800comprises a first implant component 802, a second implant component 804,and an insert 806.

In the illustrated embodiment, alternative to second implant componentbeing adapted to be attached to the calcaneus, as described above,second implant component 804 is adapted to be attached to the talus 12.Alternative to including a plurality of second implant protuberances anda plurality of second implant projections that extend from secondimplant surface, second implant body 834 defines a plurality of bores912 that extend through the second implant proximal end 830 and throughthe second implant surface 838. Alternative to second implant bodydefining a recess base that is flat, or substantially flat, secondimplant body 834 defines a recess 839 having a recess base 842 that isconcave, or substantially concave. Optionally, each bore of theplurality of second implant bores 912, or a portion thereof, can becountersunk or counterbored to allow a fastener to sit flush with, orbelow, the outer surface of second implant 804. Thus, a first fasteneris disposed through a first bore defined by second implant body 834 anda second fastener is disposed through a second bore defined by secondimplant body 834. A fastener can be disposed through each bore definedby a second implant body.

In the illustrated embodiment, alternative to first implant componentbeing adapted to be attached to the talus, as described above, firstimplant component 802 is adapted to be attached to the calcaneus 14.Alternative to first implant body defining a first articulating surfacethat is concave, or substantially concave, first implant body 812defines a first articulating surface 818 that is convex, orsubstantially convex.

In the illustrated embodiment, each bore of the plurality of firstimplant bores 890 and each bore of the plurality of second implant bores912 has a bore axis that extends through its center. Each bore axis ofthe plurality of first implant bores 890 is disposed on a first planeand each bore axis of the plurality of second implant bores 912 isdisposed on a second plane that intersects the first plane at an angle.The first plane and second plane can intersect at any suitable angle,and skilled artisans will be able to select a suitable angle for a firstplane and a second plane to intersect according to a particularembodiment based on various considerations, including the structuralarrangement at a treatment site. Example angles considered suitable fora first plane and a second plane to intersect include, but are notlimited to, an angle between about 1 degree and 90 degrees, an anglebetween about 90 degrees and about 180 degrees, a 90 degree angle, asubstantially 90 degree angle, a 45 degree angle, a substantially 45degree angle, an acute angle, an obtuse angle, and any other angleconsidered suitable for a particular application. Alternatively, a firstplane that contains each bore axis of a plurality of first implant borescan extend parallel, or substantially parallel, to a second plane thatcontains each bore axis of a plurality of second implant bores.

In the illustrated embodiment, alternative to insert body defining aninsert base surface having a flat, or substantially flat, surface,insert body 864 defines an insert base surface 874 that is convex, orsubstantially convex, such that it compliments recess base 842. Inaddition, alternative to insert body defining an insert articulatingsurface that is convex, or substantially convex, insert body 864 definesan insert articulating surface 876 that is concave, or substantiallyconcave, such that it compliments first articulating surface 818. Insertarticulating surface 876 is adapted to articulate with firstarticulating surface 818.

In addition, alternative to insert body defining an insert second recessthat extends along the entirety, or a portion of, the insert distal end(e.g., second insert recess 596), insert body 864 defines a plurality ofsecond insert recesses 896. Each recess of the plurality of secondinsert recesses 896 is disposed between the insert base surface 874 andinsert articulating surface 876 and extends from the insert proximal end860 toward the insert distal end 862 to insert shoulder 870. Each recessof the plurality of second insert recesses 896 extends into insert body864 a distance that is equal to, or substantially equal to, less than,or greater than, the distance that ridge 892 extends into recess 839.Thus, each recess of the plurality of insert second recesses 896 isadapted to interact with ridge 892 of recess 839. In the illustratedembodiment, ridge 892 and each recess of the plurality of recesses 896has a tapered configuration.

FIGS. 30, 31, 32, and 33 illustrate an eighth exemplary surgical implantsystem 1000. The implant system 1000 is similar to implant system 500illustrated in FIGS. 19, 20, 21, and 22, and described above, except asdetailed below. Reference numbers in FIGS. 30, 31, 32, and 33 refer tothe same structural element or feature referenced by the same number inFIGS. 19, 20, 21, and 22, offset by 500. Thus, implant system 1000comprises a first implant component 1002, a second implant component1004, and an insert 1006.

In the illustrated embodiment, second implant body 1034 defines a recess1039 that omits the inclusion of a recess second portion (e.g., recesssecond portion 546), a plurality of recess protuberances (e.g.,plurality of recess protuberances 591), and ridge (e.g., ridge 592).Thus, recess 1039 extends from second implant proximal end 1030 tosecond implant distal end 1032 and from recess base 1042 away fromsecond implant surface 1038. Recess 1039 has a recess length 1041 and arecess width 1045. Recess length 1041 extends from the second implantproximal end 1030 to the second implant distal end 1032 and recess width1045 extends along the second implant proximal end 1030. Thus, secondimplant body 1034 defines a recess 1039 that extends the length ofsecond implant component 1004 and that omits the inclusion of a ridge(e.g., ridge 592).

In the illustrated embodiment, insert 1006 comprises an insert proximalend 1060, insert distal end 1062, and an insert body 1064. Insert body1064 defines an insert base surface 1074 and an insert articulatingsurface 1076. Insert base surface 1074 is flat, or substantially flat,and insert articulating surface 1076 has a radius of curvature thatextends from the insert proximal end 1060 to the insert distal end 1062and that is convex, or substantially convex.

Insert 1006 has an insert length 1063 that extends from the insertproximal end 1060 to the insert distal end 1062 and an insert width 1069that extends along the insert proximal end 1060. Insert length 1063 isequal to, or substantially equal to, greater than, or less than, recesslength 1041 and recess width 1069 is equal to, substantially equal to,less than, or greater than, recess width 1045.

FIGS. 34, 35, 36, and 37 illustrate a ninth exemplary surgical implantsystem 1100. The implant system 1100 is similar to implant system 600illustrated in FIGS. 23, 24, and 25, and described above, except asdetailed below. Reference numbers in FIGS. 34, 35, 36, and 37 refer tothe same structural element or feature referenced by the same number inFIGS. 23, 24, and 25, offset by 500. Thus, implant system 1100 comprisesa first implant component 1102, a second implant component 1104, and aninsert 1106.

In the illustrated embodiment, second implant body 1134 defines a recess1139 that omits the inclusion of a recess second portion (e.g., recesssecond portion 646), a plurality of recess protuberances (e.g.,plurality of recess protuberances 691), and ridge (e.g., ridge 692).Thus, recess 1139 extends from the second implant proximal end 1130 tothe second implant distal end 1132 and from recess base 1142 away fromsecond implant surface 1138. Recess 1139 has a recess length 1141 and arecess width 1145. Recess length 1141 extends from the second implantproximal end 1130 to the second implant distal end 1132 and recess width1145 extends along second implant proximal end 1130. Thus, secondimplant body 1134 defines a recess 1139 that extends the length ofsecond implant component 1104 and that omits the inclusion of a ridge(e.g., ridge 692).

In the illustrated embodiment, insert 1106 omits the inclusion of aplurality of first insert recesses (e.g., plurality of first insertrecesses 695) and second insert recess (e.g., second insert recess 696).Thus, insert 1006 comprises an insert proximal end 1160, insert distalend 1162, and an insert body 1164. Insert body 1164 defines an insertbase 1166 and an insert articulating portion 1168. Insert base 1166 hasan insert base surface 1174 and the insert articulating portion 1168 hasan insert articulating surface 1176. Insert base surface 1174 extendsfrom insert proximal end 1160 insert distal end 1162 and insertarticulating surface 176 has a radius of curvature that extends frominsert first side 1197 to insert second side 1198.

Insert base 1166 has an insert base width 1167 along the insert proximalend 1160 and the insert articulating portion 1168 has an insertarticulating width 1169 along the insert proximal end 1160. Insert basewidth 1167 is equal to, substantially equal to, less than, or greaterthan, recess width 1145. Insert articulating width 1169 is greater thaninsert base width 1167.

FIGS. 38, 39, 40, and 41 illustrate a tenth exemplary surgical implantsystem 1200. The implant system 1200 is similar to implant system 100illustrated in FIGS. 3, 4, 5, and 6, and described above, except asdetailed below. Reference numbers in FIGS. 38, 39, 40, and 41 refer tothe same structural element or feature referenced by the same number inFIGS. 3, 4, 5, and 6, offset by 1100. Thus, implant system 1200comprises a first implant component 1202, a second implant component1204, and an insert 1206.

In the illustrated embodiment, alternative to second implant componentdefining a recess and a plurality of recess projections, first implantbody 1212 defines a convex, or substantially convex, first implantsurface 1216, recess 1239, and a plurality of recess projections 1240.Recess 1239 is adapted to receive a portion, or the entirety, of insert1206. Recess 1239 has a recess length 1241, recess base 1242, recessfirst portion 1244, and a recess second portion 1246. Recess 1239extends into first implant body 1212 to recess base 1242 and from firstimplant proximal end 1208 to first implant distal end 1210. Recesslength 1241 extends from first implant proximal end 1208 to firstimplant distal end 1210.

Each projection of the plurality of recess projections 1240 extends intorecess 1239 along a portion, or the entirety, of recess length 1241 andhas a tapered edge that is adapted to interact with a portion of insert1206 to releasably attach insert 1206 to first implant component 1202.Recess base 1242 is opposably facing, or substantially opposably facing,first implant surface 1216, is concave, or substantially concave, and issmooth, substantially smooth, or uninterrupted. Recess base 1242 has aradius of curvature that extends from first implant proximal end 1208 tofirst implant distal end 1210. Recess first portion 1244 extends fromrecess base 1242 to the plurality of recess projections 1240 and has arecess first portion width 1245 along first implant proximal end 1208.Recess second portion 1246 has a recess second portion width 1247 alongfirst implant proximal end 1208 that is measured from a first recessprojection of the plurality of recess projections 1240 to a secondrecess projection of the plurality of recess projections 1240. Therecess first portion width 1245 is greater than the recess secondportion width 1247.

In the illustrated embodiment, second implant body 1234 defines aconcave, or substantially concave, second implant surface 1238 and anopposably facing, or substantially opposably facing, convex, orsubstantially convex, second articulating surface 1243. Each of thesecond implant surface 1238 and second articulating surface 1243 has aradius of curvature that extends from second implant proximal end 1230to second implant distal end 1232. Second implant surface 1238 issmooth, substantially smooth, or uninterrupted and second articulatingsurface 1243 is smooth, substantially smooth, or uninterrupted, suchthat articulation between articulating surface 1243 and insert 1206 canbe accomplished, as described in more detail herein.

In the illustrated embodiment, insert 1206 comprises an insert proximalend 1260, insert distal end 1262, and an insert body 1264. Alternativeto insert being attached to a second implant component, insert 1206 isadapted to be attached to first implant component 1202. In addition,alternative to insert body defining an insert recess and a recessshoulder, insert body 1264 defines an insert base 1266, insertarticulating portion 1268, a first insert recess 1296, and a secondinsert recess 1296′.

Insert base 1266 has an insert base surface 1274 and the insertarticulating portion 1268 has an insert articulating surface 1276. Eachof insert base surface 1274 and insert articulating portion 1268 has aradius of curvature that extends from insert proximal end 1260 to insertdistal end 1262. Insert base surface 1274 is convex, or substantiallyconvex, and is opposably facing, or substantially opposably facing,insert articulating surface 1276, which is concave, or substantiallyconcave. Insert base surface 1274 is smooth, substantially smooth, oruninterrupted, and is complementary to recess base 1242 such that insert1206 is slidable along recess base 1242 and releasable attachmentbetween insert 1206 and first implant component 1202 can beaccomplished. Insert articulating surface 1276 is smooth, substantiallysmooth, or uninterrupted, and is complementary to second articulatingsurface 1243 such that insert 1206 can articulate with second implantcomponent 1204. Thus, insert articulating surface 1276 is adapted toarticulate with second articulating surface 1243.

Insert base 1266 has an insert base width 1267 along insert proximal end1260 and insert articulating portion 1268 has an insert articulatingwidth 1269 along insert proximal end 1260. Insert base width 1267 isequal to, substantially equal to, less than, or greater than, recessfirst portion width 1245. Insert articulating width 1269 is greaterthan, recess second portion width 1247.

Each of first insert recess 1296 and second insert recess 1296′ extendsinto recess body 1264 between insert base 1266 and insert articulatingsurface 1276. First insert recess 1296 extends along insert first side1297 and second insert recess 1296′ extends along insert second side1298. Each of the first insert recess 1296 and second insert recess1296′ extends into insert body 1264 a distance that is equal to, orsubstantially equal to, less than, or greater than, the distance that aprojection of the plurality of projections 1270 extends into recess1239. It is considered advantageous to include an insert 1206 having ainsert articulating width 1269 that is greater than the recess secondportion width 1247 and a first insert recess 1296 and second insertrecess 1296′ at least because this structural arrangement provides amechanism for achieving a slideably engagement between a first implantcomponent 1202 and an insert.

FIGS. 42, 43, 44, and 45 illustrate an eleventh exemplary surgicalimplant system 1300. The implant system 1300 is similar to implantsystem 1200 illustrated in FIGS. 38, 39, 40, and 41, and describedabove, except as detailed below. Reference numbers in FIGS. 42, 43, 44,and 45 refer to the same structural element or feature referenced by thesame number in FIGS. 38, 39, 40, and 41, offset by 100. Thus, implantsystem 1300 comprises a first implant component 1302, a second implantcomponent 1304, and an insert 1306.

In the illustrated embodiment, first implant component 1302 includes aplurality of first implant projections 1314, a first implant tab 1377,and a plurality of fasteners 1378 and second implant component 1304includes a plurality of second implant projections 1336, a secondimplant tab 1383, and a plurality of fasteners 1378. The plurality offirst implant projections 1314 is similar to the plurality of firstimplant projections 214 illustrated in FIGS. 7, 8, 9, and 10. Firstimplant tab 1377 is similar to first implant tab 277 illustrated inFIGS. 7, 8, 9, and 10. The plurality of fasteners 1378 is similar to theplurality of fasteners 278 illustrated in FIGS. 7, 8, 9, and 10. Theplurality of second implant projections 1336 is similar to the pluralityof second implant projections 236 illustrated in FIGS. 7, 8, 9, and 10.Second implant tab 1383 is similar to second implant tab 283 illustratedin FIGS. 7, 8, 9, and 10. Reference numbers relating to the plurality offirst implant projections 1314, first implant tab 1377, plurality offasteners 1378, plurality of second implant projections 1336, secondimplant tab 1383 in FIGS. 42, 43, 44, and 45 refer to the samestructural element or feature referenced by the same number in FIGS. 7,8, 9, and 10, offset by 1100.

Thus, first implant tab 1377 comprises a first implant tab wall 1379that defines a plurality of first implant bores 1380, each fastener ofthe plurality of fasteners 1378 has a fastener first end 1381 and afastener second end 1382, and second implant tab comprises a secondimplant tab wall 1384 that defines a plurality of second implant bores1385. Optionally, each bore of the plurality of first implant bores1380, or a portion thereof, can be countersunk or counterbored to allowa fastener to sit flush with, or below, the outer surface of firstimplant 1302 and each bore of the plurality of second implant bores1385, or a portion thereof, can be countersunk or counterbored to allowa fastener to sit flush with, or below, the outer surface of secondimplant 1304. Thus, a first fastener is disposed through a first boredefined by first implant tab wall 1379 and a second fastener is disposedthrough a second bore defined by first implant tab wall 1379 and a firstfastener is disposed through a first bore defined by second implant tabwall 1384 and a second fastener is disposed through a second boredefined by second implant tab wall 1384. A fastener can be disposedthrough each bore defined by a first implant tab wall and/or secondimplant tab wall.

In the illustrated embodiment, each bore of the plurality of firstimplant bores 1380 and each bore of the plurality of second implantbores 1385 has a bore axis that extends through its center. Each boreaxis of the plurality of first implant bores 1380 is disposed on a firstplane and each bore axis of the plurality of second implant bores 1385is disposed on a second plane that intersects the first plane at anangle. The first plane and second plane can intersect at any suitableangle, and skilled artisans will be able to select a suitable angle fora first plane and a second plane to intersect according to a particularembodiment based on various considerations, including the structuralarrangement at a treatment site. Example angles considered suitable fora first plane and a second plane to intersect include, but are notlimited to, an angle between about 1 degree and 90 degrees, an anglebetween about 90 degrees and about 180 degrees, a 90 degree angle, asubstantially 90 degree angle, a 45 degree angle, a substantially 45degree angle, an acute angle, an obtuse angle, and any other angleconsidered suitable for a particular application. Alternatively, a firstplane that contains each bore axis of a plurality of first implant borescan extend parallel, or substantially parallel, to a second plane thatcontains each bore axis of a plurality of second implant bores.

While particular combinations of implant components, inserts, andfeatures thereof have been described and illustrated herein, an implantsystem can combine any suitable implant component, insert, and/orfeature thereof in any suitable manner to form an implant system.Skilled artisans will be able to select a suitable implant component,insert, and/or feature thereof to form an implant system according to aparticular embodiment based on various considerations, including thestructural arrangement at an implant site.

Various methods of treatment are described and illustrated. While themethods described herein are shown and described as a series of acts, itis to be understood and appreciated that the methods are not limited bythe order of acts, as one or more acts may, in accordance with thesemethods, occur in different orders with one or more other acts describedherein, or any other suitable act(s), concurrently with one or moreother acts described herein, or any other suitable act(s), and/or in thealternative to one or more other acts described herein, or any othersuitable act(s).

FIG. 46 is a flowchart representation of an exemplary method 1400 ofmodifying a joint.

An initial step 1402 comprises creating an opening in a body to provideaccess to a joint formed between a first bone and a second bone. Anotherstep 1404 comprises locating the first bone of the joint. Another step1406 comprises locating the second bone of the joint. Another step 1408comprises removing a first portion of the first bone to configure thefirst bone to receive a first implant component. Another step 1410comprises removing a first portion of the second bone to configure thesecond bone to receive a second implant component. Another step 1412comprises installing the first implant component on the first bone.Another step 1414 comprises installing the second implant component onthe second bone. Another step 1416 comprises installing an insert on oneof the first implant component or second implant component. Another step1418 comprises closing the opening.

The step 1402 of creating an opening can be accomplished using anysuitable tool and/or method of creating an opening (e.g., in a body) andcan be created at any suitable location on a body, and skilled artisanswill be able to select a suitable tool and/or method to create anopening and a suitable location on a body to create an opening accordingto a particular embodiment based on various considerations, includingthe size and location of the opening. Example methods and/or toolsconsidered suitable for creating an opening include, but are not limitedto, scalpels, lasers, and any other tool and/or method consideredsuitable for a particular application. Example locations consideredsuitable to create an opening on a body include, but are not limited to,on the foot, on the ankle, lateral portion of the foot, posterior andlateral portion of the foot, medial portion of the foot, posterior andmedial portion of the foot, and any other location considered suitablefor a particular application.

While step 1402 has been illustrated and described as being an initialstep to methodology 1400, any other suitable step can be completed priorto the step of creating on opening to provide access to a joint, andskilled artisans will be able to select a suitable step to completeprior to creating an opening to provide access to a joint according to aparticular embodiment based on various considerations, including thelocation of the joint intended to be treated. An example step that canbe completed prior to the step of creating an opening includes, but isnot limited to, preparing the location of a desired opening for anincision (e.g., cleaning the area).

The step 1404 of locating the first bone of the joint, and the step 1406of locating the second bone of the joint, can each be accomplished usingany suitable method of visualization, and skilled artisans will be ableto select a suitable method of visualization to locate a first boneand/or a second bone according to a particular embodiment based onvarious considerations, including the location of the first bone and/orsecond bone. Example methods of visualization considered suitableinclude, but are not limited to, direct visualization, using a scope,and any other method of visualization considered suitable for aparticular application.

The step 1408 of removing a first portion of the first bone to configurethe first bone to receive a first implant component, and the step 1410of removing a first portion of the second bone to configure the secondbone to receive a second implant component, can each be accomplishedusing any suitable technique and/or tool for removing a portion of abone (e.g., to prepare a bone to receive an implant component). Skilledartisans will be able to select a suitable technique and/or tool forremoving a portion of a bone to configure the bone to receive an implantcomponent according to a particular embodiment based on variousconsiderations, including the size and location of the implant site.

Example methods of removing a portion of a bone to configure the bone toreceive an implant component include, but are not limited to,conventional techniques, drilling, sanding, cutting, and any othermethod considered suitable for a particular application. Example toolsconsidered suitable for removing a portion of a bone to configure thebone to receive an implant component include, but are not limited to,conventional tools, drills, sanders, saws (e.g., bone saws), and anyother tool considered suitable for a particular application.

An optional step comprises testing the fit between the first implantcomponent and the first bone. Another optional step comprises testingthe fit between the second implant component and the second bone. Eachof the steps of testing the fit between the first implant component andthe first bone, and testing the fit between the second implant componentand the second bone, can be accomplished by advancing the implantcomponent toward the implant site, contacting the implant component onthe bone, and determining if a desired fit between the bone and theimplant component has been achieved. If a desired fit between the boneand the implant component has not been achieved, another optional stepcomprises removing a second portion of the first bone, and/or removing asecond portion of the second bone, to configure the first bone and/orthe second bone to receive an implant component. Alternative to, or incombination with, the step of removing a second portion of the firstbone and/or removing a second portion of the second bone, a stepcomprising fitting another implant component different than the firstimplant component and/or second implant component between the first boneand/or second bone can be completed.

Another optional step comprises preparing the surface of the bone (e.g.,first bone, second bone) to receive an implant component. This step canbe accomplished using any suitable method, material, and/or tool, andskilled artisans will be able to select a suitable method, material,and/or tool to prepare the surface of a bone to receive an implantcomponent according to a particular embodiment based on variousconsiderations, including the type of attachment desired between animplant component and the bone. Examples methods, materials, and/ortools considered suitable to prepare the surface of the bone to receivean implant component include, but are not limited to, using an abrasive,using an air-powered abrasive unit, etching the bone, cleaning the bone,and any other method, material, and/or tool considered suitable for aparticular application.

The step 1412 of installing the first implant component on the firstbone, and the step 1414 of installing the second implant component onthe second bone, can each be accomplished using any suitable method ofattachment and/or any suitable tool. Example methods of attachmentand/or tools considered suitable include, but are not limited to, usinga peg, tab, keel, fastener, screw, bolt, adhesive, cement, and any othermethod of attachment and/or tool considered suitable for a particularapplication.

The step 1416 of installing an insert on one of the first implantcomponent or second implant component can be accomplished by advancingthe insert toward the implant site, and/or by inserting the insert intoone of the first implant component or second implant component. Forexample, this step can be accomplished by placing an insert in a recessdefined by an implant component.

An optional step comprises attaching the insert to one of the firstimplant component or second implant component. This step can beaccomplished using any suitable method of attachment and/or any suitabletool. Example methods of attachment and/or tools considered suitableinclude, but are not limited to, using a fastener, screw, bolt,adhesive, cement, and any other method of attachment and/or toolconsidered suitable for a particular application.

The step 1418 of closing the opening can be accomplished using anysuitable method of closing an opening, and/or by using any suitabledevice, and skilled artisans will be able to select a suitable methodand/or device for closing an opening according to a particularembodiment based on various considerations, including the location andsize of the opening. Example methods and/or devices considered suitablefor closing an opening include, but are not limited to, using sutures,staples, strips, glues (e.g., liquid tissue glues), and any other methodand/or device considered suitable for a particular application.

Methodology 1400 can accomplished on any suitable joint (e.g., in abody), and skilled artisans will be able to select a suitable joint toperform a method described herein according to a particular embodimentbased on various considerations, including the desired treatmentintended to be performed. Example joints considered suitable to performa methodology described herein include, but are not limited to, thesubtalar joint, talonavicular joint, calcaneocuboid joint, and any otherjoint considered suitable for a particular application.

While various steps, alternative steps, and/or optional steps have beendescribed above with respect to an exemplary method of treatment 1400,these steps, alternative steps, and/or optional steps can be includedin, accomplished concurrently with, and/or accomplished in thealternative to, the methodologies, steps, alternative steps, and/oroptional steps described herein with respect to exemplary method oftreatment 1500, exemplary method of treatment 1600, and/or exemplarymethod of treatment 1700.

FIG. 47 is a flowchart representation of an exemplary method 1500 ofmodifying the subtalar joint.

An initial step 1502 comprises creating an opening to provide access tothe subtalar joint formed between the talus and calcaneus. Another step1504 comprises locating the talus. Another step 1506 comprises locatingthe calcaneus. Another step 1508 comprises removing a first portion ofthe talus to configure the talus to receive a first implant component.Another step 1510 comprises removing a first portion of the calcaneus toconfigure the calcaneus to receive a second implant component. Anotherstep 1512 comprises installing the first implant component on the talus.Another step 1514 comprises installing the second implant component onthe calcaneus. Another step 1516 comprises installing an insert on oneof the first implant component or second implant component. Another step1518 comprises closing the opening.

The step 1502 of creating an opening to provide access to the subtalarjoint formed between the talus and calcaneus can be accomplished bycreating an opening at any suitable location, and skilled artisans willbe able to select a suitable location to create an opening according toa particular embodiment based on various considerations, including thesize of the implant components intended to be used. Example locationsconsidered suitable to create an opening include, but are not limitedto, creating an opening such that a lateral approach of the subtalarjoint can be accomplished, creating an opening such that a medialapproach of the subtalar joint can be accomplished, creating an openingsuch that a posterior and lateral approach of the subtalar joint can beaccomplished, creating an opening such that a posterior and medialapproach of the subtalar joint can be accomplished, and any otherlocation considered suitable for a particular application. For example,an opening can be created at, near, behind, and/or around the peronealtendons (e.g., between the peroneal tendons and the Achilles tendon).

An alternative step to the step 1512 of installing the first implantcomponent on the talus comprises installing a second implant componenton the talus. An alternative step to the step 1514 of installing thesecond implant component on the calcaneus comprises installing a firstimplant component on the calcaneus.

While various steps, alternative steps, and/or optional steps have beendescribed above with respect to an exemplary method of treatment 1500,these steps, alternative steps, and/or optional steps can be includedin, accomplished concurrently with, and/or accomplished in thealternative to, the methodologies, steps, alternative steps, and/oroptional steps described herein with respect to exemplary method oftreatment 1400, exemplary method of treatment 1600, and/or exemplarymethod of treatment 1700.

FIG. 48 is a flowchart representation of an exemplary method 1600 ofmodifying the calcaneocuboid joint.

An initial step 1602 comprises creating an opening to provide access tothe calcaneocuboid joint formed between the calcaneus and cuboid.Another step 1604 comprises locating the calcaneus. Another step 1606comprises locating the cuboid. Another step 1608 comprises removing afirst portion of the calcaneus to configure the calcaneus to receive afirst implant component. Another step 1610 comprises removing a firstportion of the cuboid to configure the cuboid to receive a secondimplant component. Another step 1612 comprises installing the firstimplant component on the calcaneus. Another step 1614 comprisesinstalling the second implant component on the cuboid. Another step 1616comprises installing an insert on one of the first implant component orsecond implant component. Another step 1618 comprises closing theopening.

The step 1602 of creating an opening to provide access to thecalcaneocuboid joint formed between the calcaneus and cuboid can beaccomplished by creating an opening at any suitable location, andskilled artisans will be able to select a suitable location to create anopening according to a particular embodiment based on variousconsiderations, including the size of the implant components intended tobe used. Example locations considered suitable to create an openinginclude, but are not limited to, creating an opening such that a lateralapproach of the calcaneocuboid joint can be accomplished, creating anopening such that a medial approach of the calcaneocuboid joint can beaccomplished, and any other location considered suitable for aparticular application. For example, an opening can be created at, near,behind, and/or around the extensor brevis.

An alternative step to the step 1612 of installing the first implantcomponent on the calcaneus comprises installing a second implantcomponent on the calcaneus. An alternative step to the step 1614 ofinstalling the second implant component on the cuboid comprisesinstalling a first implant component on the cuboid.

While various steps, alternative steps, and/or optional steps have beendescribed above with respect to an exemplary method of treatment 1600,these steps, alternative steps, and/or optional steps can be includedin, accomplished concurrently with, and/or accomplished in thealternative to, the methodologies, steps, alternative steps, and/oroptional steps described herein with respect to exemplary method oftreatment 1400, exemplary method of treatment 1500, and/or exemplarymethod of treatment 1700.

FIG. 49 is a flowchart representation of an exemplary method 1700 ofmodifying the talonavicular joint.

An initial step 1702 comprises creating an opening to provide access tothe talonavicular joint formed between the talus and navicular. Anotherstep 1704 comprises locating the talus. Another step 1706 compriseslocating the navicular. Another step 1708 comprises removing a firstportion of the talus to configure the talus to receive a first implantcomponent. Another step 1710 comprises removing a first portion of thenavicular to configure the navicular to receive a second implantcomponent. Another step 1712 comprises installing the first implantcomponent on the talus. Another step 1714 comprises installing thesecond implant component on the navicular. Another step 1716 comprisesinstalling an insert on one of the first implant component or secondimplant component. Another step 1718 comprises closing the opening.

The step 1702 of creating an opening to provide access to thetalonavicular joint formed between the talus and navicular can beaccomplished by creating an opening at any suitable location, andskilled artisans will be able to select a suitable location to create anopening according to a particular embodiment based on variousconsiderations, including the size of the implant components intended tobe used. Example locations considered suitable to create an openinginclude, but are not limited to, creating an opening such that a lateralapproach of the talonavicular joint can be accomplished, creating anopening such that a medial approach of the talonavicular joint can beaccomplished, and any other location considered suitable for aparticular application.

An alternative step to the step 1712 of installing the first implantcomponent on the talus comprises installing a second implant componenton the talus. An alternative step to the step 1714 of installing thesecond implant component on the navicular comprises installing a firstimplant component on the navicular.

While various steps, alternative steps, and/or optional steps have beendescribed above with respect to an exemplary method of treatment 1700,these steps, alternative steps, and/or optional steps can be includedin, accomplished concurrently with, and/or accomplished in thealternative to, the methodologies, steps, alternative steps, and/oroptional steps described herein with respect to exemplary method oftreatment 1400, exemplary method of treatment 1500, and/or exemplarymethod of treatment 1600.

FIGS. 50, 51, 52, and 53 illustrate a twelfth exemplary surgical implantsystem 1800. The implant system 1800 is similar to implant system 500illustrated in FIGS. 19, 20, 21, and 22, and described above, except asdetailed below. Reference numbers in FIGS. 50, 51, 52, and 53 refer tothe same structural element or feature referenced by the same number inFIGS. 19, 20, 21, and 22, offset by 1500. Thus, implant system 1800comprises a first implant component 1802, a second implant component1804, and an insert 1806.

In the illustrated embodiment, alternative to first implant bodydefining a plurality of bores that extend through the first implantproximal end and through the first implant surface, first implant body1812 defines a plurality of first implant protuberances 1904. Eachprotuberance of the plurality of first implant protuberances 1904extends outward and away from the first implant surface 1816 from aprotuberance first end 1906 toward first implant distal end 1810 to aprotuberance second end 1908 at an acute, or substantially acute, anglewith respect to first implant surface 1816. The first implant body 1812defines a passageway 1910 through each protuberance of the plurality offirst implant protuberances 1904 and that extends from a first openingdefined on the first implant proximal end 1808 to a second openingdefined on the protuberance second end 1908. Each passageway 1910provides access for passing a fastener of the plurality of fasteners1878 through a protuberance of the plurality of protuberances 1904 toattach, or assist with attaching, first implant component 1802 at animplant site. Optionally, each passageway 1910 defined by first implantbody 1812, or a portion thereof, can be countersunk or counterbored toallow a fastener to sit flush with, or below, the outer surface of firstimplant 1802. Thus, a first fastener is disposed through a firstpassageway defined by first implant body 1812 and a second fastener isdisposed through a second passageway defined by first implant body 1812.A fastener can be disposed through each passageway defined by a firstimplant body.

In the illustrated embodiment, each passageway 1910 defined by firstimplant body 1812 has a passageway axis that extends through its centerand each passageway 1889 defined by second implant body 1834 has apassageway axis that extends through its center. Each passageway axis ofeach passageway 1910 defined by first implant body 1812 is disposed on afirst plane and each passageway axis of each passageway 1889 defined bysecond implant body 1834 is disposed on a second plane that intersectsthe first plane at an angle. The first plane and second plane canintersect at any suitable angle, and skilled artisans will be able toselect a suitable angle for a first plane and a second plane tointersect according to a particular embodiment based on variousconsiderations, including the structural arrangement at a treatmentsite. Example angles considered suitable for a first plane and a secondplane to intersect include, but are not limited to, an angle betweenabout 1 degree and 90 degrees, an angle between about 90 degrees andabout 180 degrees, a 90 degree angle, a substantially 90 degree angle, a45 degree angle, a substantially 45 degree angle, an acute angle, anobtuse angle, and any other angle considered suitable for a particularapplication. Alternatively, a first plane that contains each passagewayaxis of each passageway defined by a first implant component can extendparallel, or substantially parallel, to a second plane that containseach passageway axis of each passageway defined by a second implantcomponent.

While a plurality of first implant protuberances 1904 have beenillustrated and described, the body of an implant component can defineany suitable number of protuberances, and skilled artisans will be ableto select a suitable number of protuberances for inclusion in an implantcomponent according to a particular embodiment based on variousconsiderations, including the structural configuration at an implantsite. Example number of protuberances considered suitable include toinclude in an implant component include, but are not limited to, one, atleast one, two, three, four, a plurality, and any other numberconsidered suitable for a particular application.

While second implant component 1804 is shown as including a plurality ofsecond implant projections 1836, a second implant component can omit theinclusion of a plurality of second implant projections. Alternatively,in addition to second implant 1804 including a plurality of secondimplant projections 1836, a first implant can include a plurality offirst implant projections.

FIGS. 54, 55, 56, and 57 illustrate a thirteenth exemplary surgicalimplant system 2000. The implant system 2000 is similar to implantsystem 800 illustrated in FIGS. 26, 27, 28, and 29, and described above,except as detailed below. Reference numbers in FIGS. 54, 55, 56, and 57refer to the same structural element or feature referenced by the samenumber in FIGS. 26, 27, 28, and 29, offset by 1200. Thus, implant system2000 comprises a first implant component 2002, a second implantcomponent 2004, and an insert 2006.

In the illustrated embodiment, alternative to including a plurality ofbores that extend through the second implant proximal end and throughthe second implant surface, second implant body 2034 defines a pluralityof second implant protuberances 2086. Each protuberance of the pluralityof second implant protuberances 2086 extends outward and away from thesecond implant surface 2038 from a protuberance first end 2087 towardsecond implant distal end 2032 to a protuberance second end 2088 at anacute, or substantially acute, angle with respect to second implantsurface 2038. The second implant body 2034 defines a passageway 2089through each protuberance of the plurality of second implantprotuberances 2086 and that extends from a first opening defined on thesecond implant proximal end 2030 to a second opening defined on theprotuberance second end 2088. Each passageway 2089 provides access forpassing a fastener of the plurality of fasteners 2078 through aprotuberance of the plurality of protuberances 2086 to attach, or assistwith attaching, second implant component 2004 at an implant site. Thus,a first fastener is disposed through a first passageway defined bysecond implant body 2034 and a second fastener is disposed through asecond passageway defined by second implant body 2034. A fastener can bedisposed through each passageway defined by a second implant body.

In the illustrated embodiment, alternative to first implant bodydefining a plurality of bores that extend through the first implantproximal end and through the first implant surface, first implant body2012 defines a plurality of first implant protuberances 2104. Eachprotuberance of the plurality of first implant protuberances 2104extends outward and away from the first implant surface 2016 from aprotuberance first end 2106 toward first implant distal end 2010 to aprotuberance second end 2108 at an acute, or substantially acute, anglewith respect to first implant surface 2016. The first implant body 2012defines a passageway 2110 through each protuberance of the plurality offirst implant protuberances 2104 and that extends from a first openingdefined on the first implant proximal end 2008 to a second openingdefined on the protuberance second end 2108. Each passageway 2110provides access for passing a fastener of the plurality of fasteners2078 through a protuberance of the plurality of protuberances 2104 toattach, or assist with attaching, first implant component 2002 at animplant site. Optionally, each passageway 2089 defined by second implantbody 2034, or a portion thereof, can be countersunk or counterbored toallow a fastener to sit flush with, or below, the outer surface ofsecond implant 2004 and each passageway 2110 defined by first implantbody 2012, or a portion thereof, can be countersunk or counterbored toallow a fastener to sit flush with, or below, the outer surface of firstimplant 2002. Thus, a first fastener is disposed through a firstpassageway defined by first implant body 2012 and a second fastener isdisposed through a second passageway defined by first implant body 2012.A fastener can be disposed through each passageway defined by a firstimplant body.

In the illustrated embodiment, each passageway 2110 defined by firstimplant body 2012 has a passageway axis that extends through its centerand each passageway 2089 defined by second implant body 2034 has apassageway axis that extends through its center. Each passageway axis ofeach passageway 2110 defined by first implant body 2012 is disposed on afirst plane and each passageway axis of each passageway 2089 defined bysecond implant body 2034 is disposed on a second plane that intersectsthe first plane at an angle. The first plane and second plane canintersect at any suitable angle, and skilled artisans will be able toselect a suitable angle for a first plane and a second plane tointersect according to a particular embodiment based on variousconsiderations, including the structural arrangement at a treatmentsite. Example angles considered suitable for a first plane and a secondplane to intersect include, but are not limited to, an angle betweenabout 1 degree and 90 degrees, an angle between about 90 degrees andabout 180 degrees, a 90 degree angle, a substantially 90 degree angle, a45 degree angle, a substantially 45 degree angle, an acute angle, anobtuse angle, and any other angle considered suitable for a particularapplication. Alternatively, a first plane that contains each passagewayaxis of each passageway defined by a first implant component can extendparallel, or substantially parallel, to a second plane that containseach passageway axis of each passageway defined by a second implantcomponent.

The foregoing detailed description provides exemplary embodiments of theinvention and includes the best mode for practicing the invention. Thedescription and illustration of embodiments is intended only to provideexamples of the invention, and not to limit the scope of the invention,or its protection, in any manner.

1. A system for use in a joint arthroplasty, the system comprising: afirst implant component having a first implant proximal end, a firstimplant distal end, and a first implant body defining a porous firstimplant surface, a concave first articulating surface opposably facingthe porous first implant surface, and a plurality of first implantprojections extending outward and away from the first implant surfacefrom a first implant projection first end to a first implant projectionsecond end for each of said plurality of projections; a second implantcomponent having a second implant proximal end, a second implant distalend, and a second implant body defining a second implant surface, arecess extending into the second implant body from a side opposablyfacing the second implant surface to a recess base, at least one secondimplant protuberance extending outward and away from the second implantsurface from a second implant protuberance first end to a second implantprotuberance second end, and a passageway extending from a first openingdefined on the recess base to a second opening defined on the secondimplant protuberance second end; and an insert adapted to be releasablyattached to the second implant component and having an insertarticulating surface that is convex and adapted to articulate with thefirst articulating surface, wherein said joint is selected from thegroup consisting of a subtalar joint, a calcaneocuboid joint, and atalonavicular joint and said porous first implant surface and saidsecond implant surface are configured for implanting within said joint.2. The system of claim 1, wherein the recess extends from the secondimplant proximal end toward the second implant distal end and has arecess first portion extending from the recess base and away from thesecond implant surface and a recess second portion extending from therecess first portion and configured to provide a slideable engagementbetween said second implant component and said insert.
 3. The system ofclaim 2, wherein the recess first portion has a recess first portionwidth along the second implant proximal end; wherein the recess secondportion has a recess second portion width along the second implantproximal end; and wherein the recess first portion width is differentthan the recess second portion width.
 4. (canceled)
 5. The system ofclaim 1, wherein the first implant body further comprises a plurality offirst implant protuberances and a plurality of passageways, eachprotuberance of the plurality of first implant protuberances extendingoutward and away from the first implant surface from a first implantprotuberance first end to a first implant protuberance second end, eachpassageway extending from a first opening defined on the first implantproximal end to a second opening defined on a first implant protuberancesecond end; and wherein the second implant body comprises a plurality ofsecond implant protuberances and a plurality of passageways, eachprotuberance of the plurality of second implant protuberances extendingoutward and away from the second implant surface from a second implantprotuberance first end to a second implant protuberance second end, eachpassageway extending from a first opening defined on the second implantproximal end to a second opening defined on a second implantprotuberance second end.
 6. (canceled)
 7. (canceled)
 8. The system ofclaim 1, the system further comprising a second fastener disposedthrough the passageway.
 9. The system of claim 1, wherein the insert isformed of ultra-high-molecular-weight polyethylene.
 10. The system ofclaim 1, wherein the first implant component is adapted to be attachedto the talus; and wherein the second implant component is adapted to beattached to the calcaneus.
 11. A system for use in a joint arthroplastyin a foot, the system comprising: a first implant component having afirst implant proximal end, a first implant distal end, and a firstimplant body defining a first implant surface, a concave firstarticulating surface opposably facing the first implant surface, and aplurality of first implant projections extending outward and away fromthe first implant surface from a first implant projection first end to afirst implant projection second end for each of said plurality ofprojections; a second implant component having a second implant proximalend, a second implant distal end, and a second implant body defining asecond implant surface, a recess extending into the second implant bodyfrom a side opposably facing the second implant surface to a recess baseand from the second implant proximal end toward the second implantdistal end, and a plurality of second implant projections extendingoutward and away from the second implant surface from a first implantprojection first end to a first implant projection second end for eachof said plurality of projections, the recess having a recess firstportion extending from the recess base and away from the second implantsurface and a recess second portion extending from the recess firstportion; and an insert adapted to be releasably attached to the secondimplant component and having an insert articulating surface that isconvex and adapted to articulate with the first articulating surface,wherein said joint is selected from the group consisting of a subtalarjoint, a calcaneocuboid joint, and a talonavicular joint and said porousfirst implant surface and said second implant surface are configured forimplanting within said joint.
 12. The system of claim 11, wherein therecess first portion has a recess first portion width along the secondimplant proximal end; wherein the recess second portion has a recesssecond portion width along the second implant proximal end; and whereinthe recess first portion width is different than the recess secondportion width.
 13. (canceled)
 14. The system of claim 11, wherein thefirst implant body further comprises a plurality of first implantprotuberances and a plurality of passageways, each protuberance of theplurality of first implant protuberances extending outward and away fromthe first implant surface from a first implant protuberance first end toa first implant protuberance second end, each passageway extending froma first opening defined on the first implant proximal end to a secondopening defined on a first implant protuberance second end; and whereinthe second implant body further comprises a plurality of second implantprotuberances and a plurality of passageways, each protuberance of theplurality of second implant protuberances extending outward and awayfrom the second implant surface from a second implant protuberance firstend to a second implant protuberance second end, each passagewayextending from a first opening defined on the second implant proximalend to a second opening defined on a second implant protuberance secondend.
 15. The system of claim 14, wherein each passageway defined by thefirst implant body has a passageway axis; wherein each passagewaydefined by the second implant body has a passageway axis; wherein eachpassageway axis of each passageway defined by the first implant body isdisposed on a first plane; and wherein each passageway axis of eachpassageway defined by the second implant body is disposed on a secondplane.
 16. (canceled)
 17. The system of claim 14, the system furthercomprising a first fastener disposed through the passageway defined bythe first implant component; and a second fastener disposed through thepassageway defined by the second implant component.
 18. The system ofclaim 11, wherein the insert is formed of ultra-high-molecular-weightpolyethylene.
 19. The system of claim 11, wherein the first implantcomponent is adapted to be attached to the talus; and wherein the secondimplant component is adapted to be attached to the calcaneus.
 20. Asystem for use in a joint arthroplasty, the system comprising: a firstimplant component having a first implant proximal end, a first implantdistal end, and a first implant body defining a first implant surface, aconcave first articulating surface opposably facing the first implantsurface, and a plurality of first implant bores, each bore having a boreaxis that extends through each bore center; a second implant componenthaving a second implant proximal end, a second implant distal end, and asecond implant body defining a second implant surface, a recessextending into the second implant body from a side opposably facing thesecond implant surface to a recess base and from the second implantproximal end toward the second implant distal end, and a plurality ofsecond implant bores, each bore having a bore axis that extends througheach bore center, the recess having a recess first portion extendingfrom the recess base and away from the second implant surface and arecess second portion extending from the recess first portion; and aninsert adapted to be releasably attached to the second implant componentand having an insert articulating surface that is concave and adapted toarticulate with the first articulating surface, wherein said joint isselected from the group consisting of a subtalar joint, a calcaneocuboidjoint, and a talonavicular joint and said first implant surface and saidsecond implant surface are configured for implanting within said joint.21. The system of claim 1, wherein said first implant component furthercomprises at least one first implant protuberance extending outward andaway from the first implant surface and a passageway extending from afirst opening defined on a first end of said at least one first implantprotuberance to a second opening defined on a second end of said atleast one first implant protuberance.
 22. The system of claim 11,wherein said first implant component further comprises at least onefirst implant protuberance extending outward and away from the firstimplant surface and a passageway extending from a first opening definedon a first end of said at least one first implant protuberance to asecond opening defined on a second end of said at least one firstimplant protuberance.
 23. The system of claim 22, wherein said secondimplant component further comprises at least one second implantprotuberance extending outward and away from the second implant surfaceand a passageway extending from a first opening defined on a first endof said at least one second implant protuberance to a second openingdefined on a second end of said at least one second implantprotuberance.
 24. The system of claim 23, the system further comprisinga first fastener disposed through the passageway defined by the firstimplant component and a second fastener disposed through the passagewaydefined by the second implant component.
 25. A method of using thesystem of claim 1, comprising installing said first implant componentonto a first bone of said joint and installing said second implantcomponent to a second bone of said joint.